BLOOM MENTAL WELLNESS CENTER LLC NPI 1053270967

NPI Information

  • NPI: 1053270967
  • Provider Name: BLOOM MENTAL WELLNESS CENTER, LLC
  • Classification: Registered Nurse - 163WP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 208 MAIN ST STE 110
    MILFORD, MA
    ZIP 01757
  • Phone: (508) 296-8603

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NPI Details

BLOOM MENTAL WELLNESS CENTER, LLC is a psychiatric/mental health registered nurse in Milford, MA. BLOOM MENTAL WELLNESS CENTER, LLC NPI is 1053270967. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

208 MAIN ST STE 110
MILFORD, MA
ZIP 01757-502
Phone: (508) 296-8603
Fax: (508) 484-6226

The provider's authorized official is Maurine Kisob .
The authorized official title is Executive Director and has the following contact phone number (508) 296-8603.

The enumeration date for this NPI number is 1/16/2026 and was last updated on 1/16/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WP0808XRegistered NursePsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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