Provider Demographics
NPI:1669193546
Name:BLOSSOM FATIMA HOME HEALTHCARE SERVICES
Entity type:Organization
Organization Name:BLOSSOM FATIMA HOME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALIEU
Authorized Official - Middle Name:ALIMAMY
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-862-5977
Mailing Address - Street 1:7627 FAIRFIELD WOODS CT APT D3
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1841
Mailing Address - Country:US
Mailing Address - Phone:703-862-5977
Mailing Address - Fax:703-890-2477
Practice Address - Street 1:7627 FAIRFIELD WOODS CT APT D3
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1841
Practice Address - Country:US
Practice Address - Phone:703-862-5977
Practice Address - Fax:703-890-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty