Organization
BLOOM TOWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AQUILLA ALI (CLINICIAN)
(267) 816-5357
Entity
Organization
Contact information
Practice address
491 BALTIMORE PIKE STE 1213, SPRINGFIELD, PA 19064-3810
(267) 816-5357
Mailing address
491 BALTIMORE PIKE STE 1213, SPRINGFIELD, PA 19064-3810
(267) 816-5357
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/03/2022
Last updated
07/28/2022
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