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General NPI Number Information
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NPI Number | 1831052927
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Entity Type | Organization
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Legal Business Name | BLOOMING INTEGRATIVE PSYCHIATRY
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 41 BRIDGE ST
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City | WEST ENFIELD
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State | ME
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Zip | 04493-4518
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Country | US
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Telephone | 207-447-7837
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Fax | 207-358-2577
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Provider Business Mailing Address
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Address Line | 41 BRIDGE ST
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City | WEST ENFIELD
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State | ME
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Zip | 04493-4518
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Country | US
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Telephone | 207-447-7837
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Fax | 207-358-2577
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Authorized Official
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Title or Position | ADVANCED PRACTICE REGISTERED NURSE
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Name | MRS. ILEANA IRINA VINTILA
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Credential | PMHNP-BC
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Telephone | 207-447-7837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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