| Bloom Town Llc | |
|
491 Baltimore Pike Ste 1213 Springfield PA 19064-3810 | |
| (267) 816-5357 | |
| Not Available |
| Full Name | Bloom Town Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 491 Baltimore Pike Ste 1213, Springfield, Pennsylvania |
| Authorized Official Name and Position | Aquilla Ali (CLINICIAN) |
| Authorized Official Contact | 2678165357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Town Llc 491 Baltimore Pike Ste 1213 Springfield PA 19064-3810 Ph: (267) 816-5357 | Bloom Town Llc 491 Baltimore Pike Ste 1213 Springfield PA 19064-3810 Ph: (267) 816-5357 |
| NPI Number | 1376282558 |
|---|---|
| Provider Enumeration Date | 06/03/2022 |
| Last Update Date | 07/28/2022 |
| Certification Date | 07/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376282558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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