Organization
BLOOM BEHAVIORAL COMMUNITY
Active
Parent organization
IRIS HOUSE ASSISTED LIVING, LLC
Other names
Bloom Behavioral Community
Organization subpart
Yes
Provider details
NPI number
Legal business name
IRIS HOUSE ASSISTED LIVING, LLC
Authorized official
MS. JEANNETTE L EVERETTE (ADMINISTRATOR)
(602) 434-2612
Entity
Organization
Contact information
Practice address
819 W SAN MIGUEL AVE, PHOENIX, AZ 85013-1744
(602) 434-2612
Mailing address
819 W SAN MIGUEL AVE, PHOENIX, AZ 85013-1744
(602) 434-2612
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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