Organization
BLOOMING VIDAS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KILEY GIFFORD (CEO)
(575) 520-2536
Entity
Organization
Contact information
Practice address
3021 E SPRINGS RD, LAS CRUCES, NM 88011-5265
(575) 520-2536
Mailing address
3021 E SPRINGS RD, LAS CRUCES, NM 88011-5265
(575) 520-2536
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
03/05/2026
Last updated
03/05/2026
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