Provider Demographics
NPI:1215610100
Name:BLOOM AND BLOSSOM LEARNING SUPPORT
Entity type:Organization
Organization Name:BLOOM AND BLOSSOM LEARNING SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIROVA
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, LBA
Authorized Official - Phone:347-426-6590
Mailing Address - Street 1:7329 173RD ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1429
Mailing Address - Country:US
Mailing Address - Phone:347-426-6590
Mailing Address - Fax:
Practice Address - Street 1:7329 173RD ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1429
Practice Address - Country:US
Practice Address - Phone:347-426-6590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency