Provider Demographics
NPI:1124601471
Name:BLOSSOM HEALTH & WELLNESS
Entity Type:Organization
Organization Name:BLOSSOM HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, HEAD CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:BENTLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESKRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:267-494-9218
Mailing Address - Street 1:PO BOX 896
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-0896
Mailing Address - Country:US
Mailing Address - Phone:267-494-9218
Mailing Address - Fax:
Practice Address - Street 1:114A E PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-2935
Practice Address - Country:US
Practice Address - Phone:267-494-9218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)