Provider Demographics
NPI:1710770334
Name:BITE AND BLOOM COLLECTIVE LLC
Entity type:Organization
Organization Name:BITE AND BLOOM COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT EMPLOYEE/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-909-7265
Mailing Address - Street 1:846 BUNCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GALLION
Mailing Address - State:AL
Mailing Address - Zip Code:36742-3021
Mailing Address - Country:US
Mailing Address - Phone:205-909-7265
Mailing Address - Fax:
Practice Address - Street 1:846 BUNCHVILLE RD
Practice Address - Street 2:
Practice Address - City:GALLION
Practice Address - State:AL
Practice Address - Zip Code:36742-3021
Practice Address - Country:US
Practice Address - Phone:205-909-7265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty