Organization
BLOOM CHILDREN'S DEVELOPMENTAL SERVICES, LLC
Active
Other names
Bloom Children's Developmental Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA DAWN MAKAR (OWNER)
(208) 312-0891
Entity
Organization
Contact information
Practice address
10314 N BLACKTAIL AVE, BOISE, ID 83714-9696
(208) 312-0891
Mailing address
10314 N BLACKTAIL AVE, BOISE, ID 83714-9696
(208) 312-0891
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
06/29/2024
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