Provider Demographics
NPI:1821640681
Name:CHERRY BLOSSOM HOME CARE LLC
Entity Type:Organization
Organization Name:CHERRY BLOSSOM HOME CARE LLC
Other - Org Name:CHERRY BLOSSOM LAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LASHANNA
Authorized Official - Middle Name:JILLIAN
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-651-9009
Mailing Address - Street 1:13003 PAYTON DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1907
Mailing Address - Country:US
Mailing Address - Phone:240-651-9009
Mailing Address - Fax:301-249-1651
Practice Address - Street 1:13003 PAYTON DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1907
Practice Address - Country:US
Practice Address - Phone:240-651-9009
Practice Address - Fax:301-249-1651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No291U00000XLaboratoriesClinical Medical Laboratory