Provider Demographics
NPI:1891576088
Name:BLOOM GROUP HOMES LLC
Entity Type:Organization
Organization Name:BLOOM GROUP HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-474-9370
Mailing Address - Street 1:782 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-1572
Mailing Address - Country:US
Mailing Address - Phone:330-474-9370
Mailing Address - Fax:
Practice Address - Street 1:469 LAMPARTER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1720
Practice Address - Country:US
Practice Address - Phone:330-474-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care