Healthcare Provider Details

I. General information

NPI: 1811835622
Provider Name (Legal Business Name): VITAL BLOOM HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 WHITE CHAPEL RD
BALTIMORE MD
21215-7331
US

IV. Provider business mailing address

3505 WHITE CHAPEL RD
BALTIMORE MD
21215-7331
US

V. Phone/Fax

Practice location:
  • Phone: 410-926-1380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL MICHELLE WATSON-INMAN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 410-926-1380