Provider Demographics
NPI:1770219511
Name:BLOOMING HOME CARE, LLC.
Entity Type:Organization
Organization Name:BLOOMING HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTOGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-510-7281
Mailing Address - Street 1:2 THAYER LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1479
Mailing Address - Country:US
Mailing Address - Phone:978-462-6162
Mailing Address - Fax:
Practice Address - Street 1:182 STATE ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-6637
Practice Address - Country:US
Practice Address - Phone:978-462-6162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care