| Blended Family Services | |
|
11511 Ragusa Dr Rancho Cucamonga CA 91701-8573 | |
| (217) 816-5410 | |
| Not Available |
| Full Name | Blended Family Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11511 Ragusa Dr, Rancho Cucamonga, California |
| Authorized Official Name and Position | Charnea Myasha Crump (OWNER) |
| Authorized Official Contact | 2178165419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blended Family Services 11511 Ragusa Dr Rancho Cucamonga CA 91701-8573 Ph: (217) 816-5410 | Blended Family Services 11511 Ragusa Dr Rancho Cucamonga CA 91701-8573 Ph: (217) 816-5410 |
| NPI Number | 1558133702 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558133702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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