Provider Demographics
NPI:1487546206
Name:BLBLOOMCARE, INC
Entity type:Organization
Organization Name:BLBLOOMCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA SEASON
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAYANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-614-1323
Mailing Address - Street 1:12117 MERRITT VILLA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4483
Mailing Address - Country:US
Mailing Address - Phone:832-614-1323
Mailing Address - Fax:
Practice Address - Street 1:12117 MERRITT VILLA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4483
Practice Address - Country:US
Practice Address - Phone:832-614-1323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities