Organization
THE BLOOM COLLECTIVE LLC
Active
Other names
The Bloom Collective
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANAY LYNN HARRIS (FOUNDER)
(202) 394-0694
Entity
Organization
Contact information
Practice address
2000 GREENMOUNT AVE STE 101, BALTIMORE, MD 21218-6164
(202) 394-0694
Mailing address
2000 GREENMOUNT AVE STE 101, BALTIMORE, MD 21218-6164
(202) 394-0694
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000000
—
MD
Enumeration date
01/27/2022
Last updated
01/27/2022
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