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General NPI Number Information
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NPI Number | 1891461679
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Entity Type | Organization
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Legal Business Name | BLOOM MENTAL HEALTH
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 26 W DRY CREEK CIR STE 710
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City | LITTLETON
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State | CO
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Zip | 80120-8065
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Country | US
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Telephone | 303-801-1776
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Fax |
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Provider Business Mailing Address
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Address Line | 26 W DRY CREEK CIR STE 710
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City | LITTLETON
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State | CO
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Zip | 80120-8065
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Country | US
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Telephone | 303-801-1776
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | DR. JADON WEBB
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Credential | MD
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Telephone | 214-629-9322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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