Provider Demographics
NPI:1093563298
Name:BUD TO BLOOM, LLC
Entity type:Organization
Organization Name:BUD TO BLOOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIZPE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:281-610-0451
Mailing Address - Street 1:3619 LEDGESTONE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-6012
Mailing Address - Country:US
Mailing Address - Phone:281-610-0451
Mailing Address - Fax:
Practice Address - Street 1:3619 LEDGESTONE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-6012
Practice Address - Country:US
Practice Address - Phone:281-610-0451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-11
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty