# BLOOM PEDIATRIC REHABILITATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Bloom Pediatric Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679373575
- **Authorized official:** MISS MICHAELA BUCKLEY M.A., CCC- SLP (CO-OWNER)
- **Authorized official phone:** (248) 270-2641

## Contact information

- **Practice address:** 220 S MAIN ST STE 120, ROYAL OAK, MI 48067-2678
- **Practice address phone:** (248) 270-2641
- **Mailing address:** 2924 PAXTON ST, FERNDALE, MI 48220-1068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/18/2025
- **Last updated:** 06/13/2025