Organization
BLOOM HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARMEN KHARI (ADMINISTRATOR)
(571) 771-4075
Entity
Organization
Contact information
Practice address
13800 COPPERMINE RD UNIT 118, HERNDON, VA 20171-6163
(571) 771-4075
(571) 771-4079
Mailing address
13800 COPPERMINE RD UNIT 118, HERNDON, VA 20171-6163
(571) 771-4075
(571) 771-4079
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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