Healthcare Provider Details

I. General information

NPI: 1285588640
Provider Name (Legal Business Name): BLOSSOM HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 EXECUTIVE PKWY STE 210
TOLEDO OH
43606-1327
US

IV. Provider business mailing address

3131 EXECUTIVE PKWY STE 210
TOLEDO OH
43606-1327
US

V. Phone/Fax

Practice location:
  • Phone: 567-469-3252
  • Fax:
Mailing address:
  • Phone: 567-469-3252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TANEJA DIXON
Title or Position: OWNER
Credential: RN
Phone: 567-469-3252