Bloom Compassionate Residential Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

BLOOM COMPASSIONATE RESIDENTIAL SERVICES LLC

Practice address

4102 Parapet CT
Fredericksburg, VA 22408-2564

Phone

(571) 518-8036

Fax

(186) 692-9826

NPI assigned

Dec 11, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kenneth Mbuen, PMHNP-BCNPI 1932938016

Title

Ceo

Phone

(336) 740-6347

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Mbuen

  • Psychiatric/Mental Health Nurse Practitioner
  • Manassas, VA
  • NPI 1932938016
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1639033871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PARAPET CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224082564",
            "telephone_number": "571-518-8036",
            "fax_number": "186-692-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PARAPET CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224082564",
            "telephone_number": "571-518-8036",
            "fax_number": "186-692-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM COMPASSIONATE RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "MBUEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-740-6347",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lori A Blosser-Milton, RPH
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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.