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General NPI Number Information
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NPI Number | 1952172504
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Entity Type | Organization
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Legal Business Name | BLOOM COORDINATION, LLC
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 5000 E LEWIS LN
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City | NAMPA
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State | ID
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Zip | 83686-9076
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Country | US
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Telephone | 208-880-4027
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3856
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City | NAMPA
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State | ID
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Zip | 83653-3717
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Country | US
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Telephone | 208-880-4027
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MATTHEW WARD
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Credential |
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Telephone | 208-598-8913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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