MEDICARE: BLOOM ADULT DAY CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	ADC000207	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710117585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM ADULT DAY CENTER INC

Provider Business Mailing Address
First Line	:	4360 WARM SPRINGS RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5481
Country	:	US
Telephone Number	:	706-221-4324
Fax Number	:	706-507-0731

Provider Business Practice Location Address
First Line	:	4360 WARM SPRINGS RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5481
Country	:	US
Telephone Number	:	706-221-4324
Fax Number	:	706-507-0731

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	JOANN HASSELL
Credential	:
Telephone Number	:	706-221-4324

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	03/17/2018

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Directions to “BLOOM ADULT DAY CENTER INC ” Practice Location

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