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Organization
SERVICE IN BLOOM, INC.
Active
Organization
SERVICE IN BLOOM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMITA MCCOY (PRESIDENT)
(312) 391-5480
Entity
Organization
Contact information
Practice address
200 E RANDOLPH ST, 5100-10, CHICAGO, IL 60601-6436
(312) 391-5480
(312) 233-0063
Mailing address
200 E RANDOLPH ST, 5100-10, CHICAGO, IL 60601-6436
(312) 391-5480
(312) 233-0063
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
3001117
IL
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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