| Bloom Behavioral Health Llc | |
|
205 W 2nd St Ste 150h Duluth MN 55802-1920 | |
| (218) 606-0819 | |
| Not Available |
| Full Name | Bloom Behavioral Health Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 205 W 2nd St Ste 150h, Duluth, Minnesota |
| Authorized Official Name and Position | Josh Mcilrath (OWNER/PARTNER) |
| Authorized Official Contact | 2186060819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Behavioral Health Llc 205 W 2nd St Ste 150h Duluth MN 55802-1920 Ph: (218) 606-0819 | Bloom Behavioral Health Llc 205 W 2nd St Ste 150h Duluth MN 55802-1920 Ph: (218) 606-0819 |
| NPI Number | 1215702311 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Medicare PECOS PAC ID | 5395186712 |
|---|---|
| Medicare Enrollment ID | O20240515003449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215702311 | NPI | - | NPPES |
| Provider Name | Joshua Mcilrath |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770027328 PECOS PAC ID: 9537500921 Enrollment ID: I20240528002906 |
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