Bland, Randy
Bland, Randy is an sole proprietor health care provider with primary practice located at 14047 W Monte Vista Rd , Goodyear AZ 85395. He recently has only one registered license in Respite Care Facility / Respite Care, Mental Illness, Child, which is considered as his primary health care specialty. Bland, Randy can be contacted via phone (480) 334-2092.Contact Information
Primary practice address
14047 W Monte Vista Rd
Goodyear AZ 85395
Phone: (480) 334-2092
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respite Care Facility / Respite Care, Mental Illness, Child | 385HR2055X | 10126301 | Arizona |
Profile Details
| NPI number | 1700423902 |
|---|---|
| LBN Legal business name | Bland, Randy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2019 |
| Last updated | Jun 29th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700423902 | NPPES |
| Arizona | Other | 1700423902 | THERAPEUTIC FOSTER CARE |
| Arizona | Other | 10126301 | THERAPEUTIC FOSTER CARE |
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