| Bloom Behavioral Therapy Llc | |
|
25b Rushmore Dr Greenville SC 29615-1254 | |
| (864) 383-0384 | |
| Not Available |
| Full Name | Bloom Behavioral Therapy Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 25b Rushmore Dr, Greenville, South Carolina |
| Authorized Official Name and Position | Madeline Lisa Rehm (OWNER) |
| Authorized Official Contact | 8643830384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Behavioral Therapy Llc 25b Rushmore Dr Greenville SC 29615-1254 Ph: () - | Bloom Behavioral Therapy Llc 25b Rushmore Dr Greenville SC 29615-1254 Ph: (864) 383-0384 |
| NPI Number | 1003312943 |
|---|---|
| Provider Enumeration Date | 03/31/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003312943 | NPI | - | NPPES |
| SW1450 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 11284 (South Carolina) | Primary |
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