Provider Demographics
NPI:1396320289
Name:BLOSSOM HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BLOSSOM HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREADA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYONEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-853-0465
Mailing Address - Street 1:9930 BUCKINGHAM RD APT 401
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2482
Mailing Address - Country:US
Mailing Address - Phone:214-853-0465
Mailing Address - Fax:
Practice Address - Street 1:9930 BUCKINGHAM RD APT 401
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2482
Practice Address - Country:US
Practice Address - Phone:214-853-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health