Provider Demographics
NPI:1649002908
Name:BLOOM HOSPICE OF TEXAS, LLC
Entity type:Organization
Organization Name:BLOOM HOSPICE OF TEXAS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-500-3030
Mailing Address - Street 1:8000 W INTERSTATE 70
Mailing Address - Street 2:STE. 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3668
Mailing Address - Country:US
Mailing Address - Phone:210-903-0000
Mailing Address - Fax:210-944-4133
Practice Address - Street 1:8000 W INTERSTATE 70
Practice Address - Street 2:STE. 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3668
Practice Address - Country:US
Practice Address - Phone:210-500-3030
Practice Address - Fax:210-352-9133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLOOM HOSPICE OF TEXAS HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-15
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based