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Bloom Mental Health And Wellness, LLC

Clinic/Center, Adult Mental Health in Lake Mary, FL. Organization (NPI-2).

NPI number1285484204
StatusActive
Last updated in NPPESNov 4, 2024

Details

NPI
1285484204
Entity type
Organization (NPI-2)
Legal business name
Bloom Mental Health And Wellness, LLC
Organization subpart
No
Enumeration date
Mar 25, 2024
Certification date
Nov 4, 2024
Last updated
Nov 4, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

1540 International Pkwy Ste 2000
Lake Mary, FL 32746-5096

Phone 407-554-9970

Mailing address

1540 International Pkwy Ste 2000
Lake Mary, FL 32746-5096

Phone 407-252-7011

Authorized official

Lari J Quintero
Owner
4072527011

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