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Organization

BLOOM HOMEHEALTH SOLUTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YETTA ADELE SAMANTHA ROTH (OWNER)
(909) 918-8922
Entity
Organization

Contact information

Practice address
2012 JUSTIN RD, LEWISVILLE, TX 75077
(214) 998-5544
Mailing address
3039 NOWITZKI WAY APT 3112, DALLAS, TX 75219-7985
(909) 918-8922

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
163WI0500X
Infusion Therapy Registered Nurse
163WP0200X
Pediatric Registered Nurse
2251G0304X
Geriatric Physical Therapist
2251P0200X
Pediatric Physical Therapist
225200000X
Physical Therapy Assistant
225X00000X
Occupational Therapist
251E00000X
Home Health Agency
Primary
251J00000X
Nursing Care Agency
363LP0200X
Pediatric Nurse Practitioner
364SH0200X
Home Health Clinical Nurse Specialist

Other

Enumeration date
10/17/2024
Last updated
10/17/2024
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