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Organization
BLOOMING HEALTH FARMS
Active
Organization
BLOOMING HEALTH FARMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN A SMITH (EXECUTIVE DIRECTOR)
(970) 381-2164
Entity
Organization
Contact information
Practice address
2116 16TH ST, GREELEY, CO 80631-5117
(970) 518-5266
Mailing address
2116 16TH ST, GREELEY, CO 80631-5117
(970) 518-5266
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000196765
—
CO
Enumeration date
10/01/2021
Last updated
10/01/2021
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