Healthcare Provider Details

I. General information

NPI: 1063361509
Provider Name (Legal Business Name): WE BLOOM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S MERIDIAN ST
INDIANAPOLIS IN
46225-1222
US

IV. Provider business mailing address

701 S MERIDIAN ST
INDIANAPOLIS IN
46225-1222
US

V. Phone/Fax

Practice location:
  • Phone: 206-940-5234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BETH KREITL
Title or Position: EXECUTIVE DIRECTOR
Credential: KREITL
Phone: 206-940-5234