MEDICARE: ADULT BLOOMING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1861359226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULT BLOOMING

Provider Business Mailing Address
First Line	:	1106 MOUNT VERNON BLVD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44112-3658
Country	:	US
Telephone Number	:	216-347-0238
Fax Number	:

Provider Business Practice Location Address
First Line	:	6524 SAINT CLAIR AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-1636
Country	:	US
Telephone Number	:	216-347-0238
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHAREEN FOUNTAIN
Credential	:
Telephone Number	:	216-347-0238

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ADULT BLOOMING ” Practice Location

Language	Start Address	Practice Location

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