| NPI | 1215640693 |
|---|---|
| Former Legal Business Name | BLOOM & BEYOND LLC |
| Entity Type | Organization |
| Authorized Contact | SHANTE LANE Owner 240-803-5263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-01-02 |