| Organization Name: | DELERISAJBLANK-INC |
| NPI Number: | 1679637987 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DELERISA JANET BLANK (OWNER) |
| Mailing Address: | 16507 Clements Rd Mount Orab |
| State: | OH US |
| Postal Code: | 451549765 |
| Phone Number: | 9374443596 |
| Fax Number: | 9374443596 |
| NPI Enumeration Date: | 12/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |