Provider Demographics
NPI:1457072050
Name:BLOOMING TREE, LLC
Entity Type:Organization
Organization Name:BLOOMING TREE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PASSARETTI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:518-472-0020
Mailing Address - Street 1:33 MAXWELL ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1609
Mailing Address - Country:US
Mailing Address - Phone:518-472-0020
Mailing Address - Fax:985-980-6508
Practice Address - Street 1:33 MAXWELL ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1609
Practice Address - Country:US
Practice Address - Phone:518-472-0020
Practice Address - Fax:985-980-6508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty