Healthcare Provider Details

I. General information

NPI: 1669193546
Provider Name (Legal Business Name): BLOSSOM FATIMA HOME HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7627 FAIRFIELD WOODS CT APT D3
LORTON VA
22079-1841
US

IV. Provider business mailing address

7627 FAIRFIELD WOODS CT APT D3
LORTON VA
22079-1841
US

V. Phone/Fax

Practice location:
  • Phone: 703-862-5977
  • Fax: 703-890-2477
Mailing address:
  • Phone: 703-862-5977
  • Fax: 703-890-2477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. ALIEU ALIMAMY KAMARA
Title or Position: OWNER/CEO
Credential:
Phone: 703-862-5977