Provider Demographics
NPI:1730937269
Name:BLOOM HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BLOOM HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BIANNCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-905-2373
Mailing Address - Street 1:34841 VETERANS PLZ
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1733
Mailing Address - Country:US
Mailing Address - Phone:734-905-2373
Mailing Address - Fax:
Practice Address - Street 1:34841 VETERANS PLZ
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1733
Practice Address - Country:US
Practice Address - Phone:734-905-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care