Organization
BLOOM WELLNESS LLC
Active
Parent organization
BLOOM WELLNESS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLOOM WELLNESS LLC
Authorized official
LAURA MAGNUSON LSCW (OWNER, SUPERVISOR, CLINICIAN)
(303) 408-8056
Entity
Organization
Contact information
Practice address
100 W BENNETT AVENUE, CRIPPLE CREEK, CO 80813
(719) 286-9077
Mailing address
417 BEAVER POND RD, DIVIDE, CO 80814-7792
(719) 286-9077
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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