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General NPI Number Information
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NPI Number | 1366370264
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Entity Type | Organization
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Legal Business Name | CAROLINA BLOOMS EARLY INTERVENTION
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 1245 CELEBRATION BLVD
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City | FLORENCE
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State | SC
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Zip | 29501-5499
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Country | US
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Telephone | 864-584-8315
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Fax | 864-551-2758
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Provider Business Mailing Address
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Address Line | 1245 CELEBRATION BLVD
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City | FLORENCE
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State | SC
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Zip | 29501-5499
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Country | US
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Telephone | 864-584-8315
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Fax | 864-551-2758
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DARRELL TENNIE
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Credential |
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Telephone | 919-217-0933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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