Provider Demographics
NPI:1164137345
Name:VERVE & BLOOM LLC
Entity Type:Organization
Organization Name:VERVE & BLOOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-499-0041
Mailing Address - Street 1:2711 N SEPULVEDA BLVD # 1009
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2725
Mailing Address - Country:US
Mailing Address - Phone:424-499-0041
Mailing Address - Fax:
Practice Address - Street 1:2711 N SEPULVEDA BLVD # 1009
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2725
Practice Address - Country:US
Practice Address - Phone:424-499-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty