| NPI | 1497482590 |
|---|---|
| Other Name | BLOOM HOUSE RESIDENTIAL TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | FREDI SHAE PROCHODA Medical Director 303-881-8598 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-08-08 |