Provider Demographics
NPI:1942867858
Name:BLOSSOM ASSISTED LIVING
Entity Type:Organization
Organization Name:BLOSSOM ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARGAR
Authorized Official - Middle Name:N
Authorized Official - Last Name:TURAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-489-6003
Mailing Address - Street 1:18030 ROLLING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1126
Mailing Address - Country:US
Mailing Address - Phone:832-489-6003
Mailing Address - Fax:
Practice Address - Street 1:18030 ROLLING CREEK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1126
Practice Address - Country:US
Practice Address - Phone:832-489-6003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility