Organization
BLOOMWELL BEHAVIORAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOGAN PRATT (CEO)
(501) 282-0630
Entity
Organization
Contact information
Practice address
2910 SUMNER BLVD STE 101, RALEIGH, NC 27616-2965
(919) 391-9087
(919) 561-6112
Mailing address
382 NE 191ST ST STE 98090, MIAMI, FL 33179-3899
(501) 282-0630
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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