MEDICARE: BLOOM CENTER FOR AUTISM SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
4	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1699621458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM CENTER FOR AUTISM SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	10 EMERSON ST
Second Line	:
City	:	SOUTH DARTMOUTH
State	:	MA
Zip	:	02748-2412
Country	:	US
Telephone Number	:	774-587-9058
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 EMERSON ST
Second Line	:
City	:	SOUTH DARTMOUTH
State	:	MA
Zip	:	02748-2412
Country	:	US
Telephone Number	:	774-587-9058
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. TRINOUGH LAEL SILVA
Credential	:	BA
Telephone Number	:	774-587-9058

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/09/2026

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