Provider Demographics
NPI:1679304703
Name:BLIST SOCIAL SERVICES LLC
Entity type:Organization
Organization Name:BLIST SOCIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-343-0665
Mailing Address - Street 1:1375 SAINT ANTHONY AVE STE 202-1
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4006
Mailing Address - Country:US
Mailing Address - Phone:651-343-0665
Mailing Address - Fax:
Practice Address - Street 1:1375 SAINT ANTHONY AVE STE 202-1
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4006
Practice Address - Country:US
Practice Address - Phone:651-343-0665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management