| Bloom Wellness Llc | |
|
100 W Bennett Avenue Cripple Creek CO 80813 | |
| (719) 286-9077 | |
| Not Available |
| Full Name | Bloom Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 100 W Bennett Avenue, Cripple Creek, Colorado |
| Authorized Official Name and Position | Laura Magnuson (OWNER, SUPERVISOR, CLINICIAN) |
| Authorized Official Contact | 3034088056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Wellness Llc 417 Beaver Pond Rd Divide CO 80814-7792 Ph: (719) 286-9077 | Bloom Wellness Llc 100 W Bennett Avenue Cripple Creek CO 80813 Ph: (719) 286-9077 |
| NPI Number | 1093523904 |
|---|---|
| Provider Enumeration Date | 12/23/2024 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093523904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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