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General NPI Number Information
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NPI Number | 1629952213
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Entity Type | Organization
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Legal Business Name | BLOOM BIRTH AND WELLNESS CENTER
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 28250 FRANKLIN RD
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1659
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Country | US
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Telephone | 616-262-7077
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Fax | 616-344-2134
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Provider Business Mailing Address
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Address Line | 28250 FRANKLIN RD
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1659
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Country | US
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Telephone | 616-262-7077
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Fax | 616-344-2134
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Authorized Official
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Title or Position | OWNER/ MIDWIFE
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Name | JENNIFER DEWAARD
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Credential |
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Telephone | 616-262-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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