Organization
BLOOM FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKITA LAKITA KENT (EXECUTIVE DIRECTOR)
(773) 676-9600
Entity
Organization
Contact information
Practice address
1701 S 1ST AVE STE 204C, MAYWOOD, IL 60153-2400
(773) 676-6900
Mailing address
1701 S 1ST AVE STE 204C, MAYWOOD, IL 60153-2400
(773) 676-6900
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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