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Organization

THE COMMUNITY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JUDITH L BLOOM MSW, LMFT (CEO)
(954) 533-9818
Entity
Organization

Contact information

Practice address
201 NE 2ND ST, FORT LAUDERDALE, FL 33301-1037
(954) 533-9818
Mailing address
1217 NE 3RD ST, FORT LAUDERDALE, FL 33301-1743
(954) 533-9818

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT2236
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT2236
STATE LICENSE NUMBER
FL
Enumeration date
04/27/2016
Last updated
04/27/2016
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