Healthcare Provider Details

I. General information

NPI: 1699621458
Provider Name (Legal Business Name): BLOOM CENTER FOR AUTISM SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 EMERSON ST
SOUTH DARTMOUTH MA
02748-2412
US

IV. Provider business mailing address

10 EMERSON ST
SOUTH DARTMOUTH MA
02748-2412
US

V. Phone/Fax

Practice location:
  • Phone: 774-587-9058
  • Fax:
Mailing address:
  • Phone: 774-587-9058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. TRINOUGH LAEL SILVA
Title or Position: OWNER
Credential: BA
Phone: 774-587-9058