| Organization Name: | IN BLOOM BEHAVIORAL HEALTH CARE |
| NPI Number: | 1104053008 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CINDY H PACKER (OWNER) |
| Mailing Address: | 15 Terry Ct Suite D Staunton |
| State: | VA US |
| Postal Code: | 244012568 |
| Phone Number: | 5408872847 |
| Fax Number: | 5408872848 |
| NPI Enumeration Date: | 06/18/2009 |
| NPI Last Update Date: | 06/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0015000751 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |