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General NPI Number Information
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NPI Number | 1003762063
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Entity Type | Organization
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Legal Business Name | FULL BLOOM HEALTH SERVICES LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 7111 ALLENTOWN RD STE 102
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City | FT WASHINGTON
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State | MD
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Zip | 20744-1539
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Country | US
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Telephone | 202-246-7428
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Fax | 240-493-7452
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Provider Business Mailing Address
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Address Line | 7111 ALLENTOWN RD STE 102
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City | FT WASHINGTON
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State | MD
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Zip | 20744-1539
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Country | US
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Telephone | 202-246-7428
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Fax | 240-493-7452
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Authorized Official
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Title or Position | CEO
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Name | AKAIRA DEHANEY
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Credential |
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Telephone | 202-246-7428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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