| Bloom Mental Health Services Llc | |
|
919 Justice Dr Locust Grove GA 30248-3661 | |
| (404) 530-9252 | |
| Not Available |
| Full Name | Bloom Mental Health Services Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 919 Justice Dr, Locust Grove, Georgia |
| Authorized Official Name and Position | Cierra Davis (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4045309252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Mental Health Services Llc 31 Pine Grove Rd # 1009 Locust Grove GA 30248-2561 Ph: () - | Bloom Mental Health Services Llc 919 Justice Dr Locust Grove GA 30248-3661 Ph: (404) 530-9252 |
| NPI Number | 1679323794 |
|---|---|
| Provider Enumeration Date | 03/22/2024 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679323794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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