Canly Blessed Group Home LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CANLY BLESSED GROUP HOME LLC

Practice address

26 SW 104TH St
Oklahoma City, OK 73139-9040

Phone

(405) 889-6273

NPI assigned

Aug 19, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lydia Bosungmeh Achirindalle

Title

Owner

Phone

(405) 889-6273

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1043197296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SW 104TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399040",
            "telephone_number": "405-889-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SW 104TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399040",
            "telephone_number": "405-889-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANLY BLESSED GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "ACHIRINDALLE",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "BOSUNGMEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-889-6273",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Stephan Cancio
• Gloria Anne Candelaria, LCSW
• Vikki Ann Canfield, M.D.
• Blair K Canis, RN
• Rochelle Canizalez, APRN
• Leah Cerise Cannady, CCC-SLP
• Courtney Marie Canning
• Lisa Anna Cannon-Stewart, OTR
• Carson Cannon
• Dylan Jace Cannon, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.