Organization
LIFE BLOOM SUPPORT & REFERRAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE SMALL JOHNSON (OWNER)
(352) 474-8519
Entity
Organization
Contact information
Practice address
101 ARTHUR ST, GREENVILLE, NC 27834-5317
(352) 474-8519
Mailing address
1306 CLARK ST, GREENVILLE, NC 27834-4056
(352) 474-8519
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
12/01/2025
Last updated
04/16/2026
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