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General NPI Number Information
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NPI Number | 1740120245
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Entity Type | Organization
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Legal Business Name | BLOOM WELLNESS CENTER INC
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 20501 VENTURA BLVD STE 380
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-6432
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Country | US
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Telephone | 747-441-1440
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Fax | 747-444-1448
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Provider Business Mailing Address
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Address Line | 20501 VENTURA BLVD STE 380
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-6432
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Country | US
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Telephone | 747-441-1440
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Fax | 747-444-1448
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Authorized Official
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Title or Position | CEO
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Name | KARINE ANDRYASYAN
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Credential |
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Telephone | 747-213-3487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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