Provider Demographics
NPI:1093470684
Name:BLOOM HOSPICE LLC
Entity Type:Organization
Organization Name:BLOOM HOSPICE LLC
Other - Org Name:BLOOM HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-459-4000
Mailing Address - Street 1:12600 W COLFAX AVE STE B200
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3736
Mailing Address - Country:US
Mailing Address - Phone:303-459-4000
Mailing Address - Fax:720-912-3300
Practice Address - Street 1:12600 W COLFAX AVE STE B200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-3736
Practice Address - Country:US
Practice Address - Phone:303-459-4000
Practice Address - Fax:720-912-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based