Provider Demographics
NPI:1114686516
Name:BABY BLOOM LLC
Entity Type:Organization
Organization Name:BABY BLOOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:MS
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-802-2285
Mailing Address - Street 1:43 WARNER ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2042
Mailing Address - Country:US
Mailing Address - Phone:954-802-2285
Mailing Address - Fax:
Practice Address - Street 1:43 WARNER ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2042
Practice Address - Country:US
Practice Address - Phone:954-802-2285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty