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General NPI Number Information
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NPI Number | 1699519124
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Entity Type | Organization
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Legal Business Name | BLOOM BEHAVIORAL HEALTH L.L.C.
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 3014 DAUPHINE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6754
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Country | US
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Telephone | 877-968-0068
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Fax | 855-538-3026
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Provider Business Mailing Address
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Address Line | 3014 DAUPHINE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6754
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Country | US
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Telephone | 877-968-0068
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Fax | 855-538-3026
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Authorized Official
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Title or Position | OWNER
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Name | CINNAMON DAVIS
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Credential | PMHNP, FNP-BC
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Telephone | 504-814-0044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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