Blume Behavioral Health LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

BLUME BEHAVIORAL HEALTH LLC

Practice address

2403 Perkins LN
Redondo Beach, CA 90278-2616

Phone

(858) 692-7742

Fax

(772) 873-9997

NPI assigned

Feb 7, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Basel Shadfan

Title

Ceo

Phone

(858) 692-7742

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1952165383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 PERKINS LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902782616",
            "telephone_number": "858-692-7742",
            "fax_number": "772-873-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 PERKINS LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902782616",
            "telephone_number": "858-692-7742",
            "fax_number": "772-873-9997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2623 Voorhees Ave",
            "address_purpose": "LOCATION",
            "city": "Redondo Beach",
            "state": "CA",
            "postal_code": "902782618",
            "country_code": "US",
            "telephone_number": "858-692-7742",
            "fax_number": "772-873-9997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUME BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "SHADFAN",
        "authorized_official_first_name": "BASEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-692-7742",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Joann Blackwell
• Diane Lisabeth Blagojevich, P.T.
• Bloom Family Wellness Center, LLC
• Blue Chair Family Therapy
• Blue Chair Foundation
• Blume Family Therapy Center Inc
• Norbertamarie Veronica Bobe-Kollmeyer, M.S.
• Bodyentre Redondo BCH
• Lizette A Bojorquez
• Katia Boone

• Psychiatric Residential Treatment Facility in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Psychiatric Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.