Organization
BLOOM CONNECT SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MBUEN PMHNP-BC (CEO/FOUNDER)
(336) 740-6347
Entity
Organization
Contact information
Practice address
4102 PARAPET CT, FREDERICKSBURG, VA 22408-2564
(336) 740-6347
Mailing address
10562 TATTERSALL DR, MANASSAS, VA 20112-2407
(336) 740-6347
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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