Provider Demographics
NPI:1801772736
Name:BLOOMING CARE SERVICE
Entity type:Organization
Organization Name:BLOOMING CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:OLUFUNMILAYO
Authorized Official - Last Name:OYEWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-585-5424
Mailing Address - Street 1:11312 LUDGATE PL
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1878
Mailing Address - Country:US
Mailing Address - Phone:804-585-5424
Mailing Address - Fax:
Practice Address - Street 1:11312 LUDGATE PL
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1878
Practice Address - Country:US
Practice Address - Phone:804-585-5424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities