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General NPI Number Information
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NPI Number | 1548114838
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Entity Type | Organization
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Legal Business Name | BLOOM BEHAVIORAL CO. LLC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 6000 JAYCOX RD APT 101
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City | NORTH RIDGEVILLE
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State | OH
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Zip | 44039-1672
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Country | US
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Telephone | 440-506-6084
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 JAYCOX RD APT 101
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City | NORTH RIDGEVILLE
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State | OH
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Zip | 44039-1672
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ BCBA
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Name | MARQUEZIA WILLIAMS
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Credential | BCBA
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Telephone | 440-506-6084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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