Provider Demographics
NPI:1053172478
Name:THE BLUE HOUSE COMPANY LLC
Entity type:Organization
Organization Name:THE BLUE HOUSE COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:586-557-6752
Mailing Address - Street 1:14040 NORMAN RD
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MI
Mailing Address - Zip Code:48097-1801
Mailing Address - Country:US
Mailing Address - Phone:586-557-6752
Mailing Address - Fax:
Practice Address - Street 1:35418 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:HARRISON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48045-3247
Practice Address - Country:US
Practice Address - Phone:586-665-7313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty