Provider Demographics
NPI:1497357792
Name:BLOOMING HOME HEALTH CARE
Entity Type:Organization
Organization Name:BLOOMING HOME HEALTH CARE
Other - Org Name:BLOOMING HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANACLET
Authorized Official - Middle Name:
Authorized Official - Last Name:MMASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-353-8888
Mailing Address - Street 1:4005 WILLIAMSBURG CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1139
Mailing Address - Country:US
Mailing Address - Phone:571-353-8888
Mailing Address - Fax:
Practice Address - Street 1:520 PUSEY AVE
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3300
Practice Address - Country:US
Practice Address - Phone:571-353-8888
Practice Address - Fax:703-866-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health