36D2148088 CLIA NUMBER - BLOOM OF GRACE REHAB, LLC

Laboratory Demographics

CLIA Number: 36D2148088

Facility Name: BLOOM OF GRACE REHAB, LLC

Facility Address:
22 CLINTON ST
BLOOMVILLE, OH
ZIP 44818
Get Directions

Facility Phone Number: (419) 983-4100

Facility Type: SKILLED NURSING/NURSING FACILITY

Certificate Type: Waiver

NPI Number: 1558861120

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	36D2148088
LAB Type	SKILLED NURSING/NURSING FACILITY
Facility Name	BLOOM OF GRACE REHAB, LLC
Street	22 CLINTON ST
City	BLOOMVILLE
State	OH
ZIP	44818
Phone	(419) 983-4100

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 5/11/2023