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General NPI Number Information
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NPI Number | 1689348161
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Entity Type | Organization
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Legal Business Name | BLOOM COMMUNITY SERVICES
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Dates
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Enumeration Date | 08/06/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 2670 106TH ST STE 220
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City | URBANDALE
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State | IA
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Zip | 50322-3746
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Country | US
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Telephone | 515-277-1050
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Fax | 515-277-1963
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Provider Business Mailing Address
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Address Line | 2670 106TH ST STE 220
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City | URBANDALE
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State | IA
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Zip | 50322-3746
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Country | US
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Telephone | 515-277-1050
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Fax | 515-277-1963
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAILA RINGGENBERG
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Credential | MSW
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Telephone | 515-277-1050
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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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