Organization
BLOOM & BEYOND LLC
Active
Other names
Bloom & Beyond LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTE LANE M.S. EDUCATION (OWNER)
(240) 803-5263
Entity
Organization
Contact information
Practice address
3081 OLD WASHINGTON RD, WALDORF, MD 20601-3122
(240) 803-5263
Mailing address
3081 OLD WASHINGTON RD, WALDORF, MD 20601-3122
(240) 803-5263
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/02/2023
Last updated
01/02/2023
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