Healthcare Provider Details

I. General information

NPI: 1912813338
Provider Name (Legal Business Name): BLOOMCARE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 7TH ST NE
ROCHESTER MN
55906-3644
US

IV. Provider business mailing address

29 7TH ST NE
ROCHESTER MN
55906-3644
US

V. Phone/Fax

Practice location:
  • Phone: 612-867-5647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMED MOHAMED
Title or Position: CREDENTIALING CONTACT
Credential:
Phone: 612-867-5647