# BLOOMING THERAPEUTIC GARDEN LLC

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790419596
- **Authorized official:** JANNA CRUZ CCC-SLP, TSSLD/BE (OWNER/QUALITY ASSURANCE PERSONNEL)
- **Authorized official phone:** (212) 795-7571

## Contact information

- **Practice address:** 809 W 177TH ST APT 3A, NEW YORK, NY 10033-6600
- **Practice address phone:** (212) 795-7571
- **Practice address fax:** (212) 795-7571
- **Mailing address:** 809 W 177TH ST APT 3A, NEW YORK, NY 10033-6600
- **Mailing address phone:** (212) 795-7571
- **Mailing address fax:** (212) 795-7571

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/15/2022
- **Last updated:** 07/15/2022