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General NPI Number Information
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NPI Number | 1861359226
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Entity Type | Organization
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Legal Business Name | ADULT BLOOMING
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 6524 SAINT CLAIR AVE
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City | CLEVELAND
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State | OH
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Zip | 44103-1636
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Country | US
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Telephone | 216-347-0238
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Fax |
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Provider Business Mailing Address
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Address Line | 1106 MOUNT VERNON BLVD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44112-3658
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Country | US
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Telephone | 216-347-0238
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHAREEN FOUNTAIN
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Credential |
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Telephone | 216-347-0238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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