Provider Demographics
NPI:1336730993
Name:ROSENBLOOM'S FARM INC.
Entity Type:Organization
Organization Name:ROSENBLOOM'S FARM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:419-346-1364
Mailing Address - Street 1:2738 SHETLAND RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1518
Mailing Address - Country:US
Mailing Address - Phone:419-346-1364
Mailing Address - Fax:
Practice Address - Street 1:2738 SHETLAND RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1518
Practice Address - Country:US
Practice Address - Phone:419-346-1364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services