| Organization Name: | BLESSED MC, LLC. |
| NPI Number: | 1023216165 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUAN ESTEBAN VILLA (PRESIDENT) |
| Mailing Address: | 34441 8 Mile Rd Ste 104 Livonia |
| State: | MI US |
| Postal Code: | 481524013 |
| Phone Number: | 3137720406 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2007 |
| NPI Last Update Date: | 07/24/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |