Organization
BLOOME BX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAIRRA J MORENO (OWNER)
(305) 600-9155
Entity
Organization
Contact information
Practice address
2304 MARBRISA CT, AUGUSTA, GA 30906-9151
(305) 600-9155
Mailing address
2304 MARBRISA CT, AUGUSTA, GA 30906-9151
(305) 600-9155
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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