Bloom Behavioral Health Llc

LBN: Bloom Behavioral Health Llc
Bloom Behavioral Health Llc is an health care organization with primary practice located at 2473 Karl Dr , Port Orange FL 32128-6511. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as the primary health care specialty. Bloom Behavioral Health Llc can be contacted via phone (904) 788-9474, or through Gonzalez, Elena via phone (904) 788-9474.

Contact Information

Primary practice address
2473 Karl Dr Port Orange FL 32128-6511
Phone: (904) 788-9474
Fax: (760) 205-4866
Website:
Map and Directions
Authorized official contact:
Name: Gonzalez, Elena LMFT
Phone: (904) 788-9474

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1114593399
LBN Legal business name Bloom Behavioral Health Llc
DBA Doing business as
Authorized official Gonzalez, Elena LMFT
Entity Organization
Organization subpart 1 No
Enumeration date May 28th, 2021
Last updated May 11th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114593399 NPPES
Other 1164790143 NPI
Other 1164790143 NPI

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