MEDICARE: BLOSSOM GROUPS CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	372500000X	Chore Provider
3	372600000X	Adult Companion
4	3747A0650X	Attendant Care Provider
5	3747P1801X	Personal Care Attendant
6	374U00000X	Home Health Aide
7	376J00000X	Homemaker
8	385H00000X	Respite Care
9	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457497232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOSSOM GROUPS CORPORATION

Provider Business Mailing Address
First Line	:	12959 JUPITER RD
Second Line	:	#253
City	:	DALLAS
State	:	TX
Zip	:	75238-5223
Country	:	US
Telephone Number	:	469-906-6359
Fax Number	:	469-906-6385

Provider Business Practice Location Address
First Line	:	12959 JUPITER RD
Second Line	:	#253
City	:	DALLAS
State	:	TX
Zip	:	75238-5223
Country	:	US
Telephone Number	:	469-906-6359
Fax Number	:	469-906-6385

Authorized Official
Title or Position	:	RN
Name	:	UKACHI AKOGU
Credential	:	ADMINISTRATOR
Telephone Number	:	469-906-6359

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	03/12/2025

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Directions to “BLOSSOM GROUPS CORPORATION ” Practice Location

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