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General NPI Number Information
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NPI Number | 1053279026
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Entity Type | Organization
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Legal Business Name | ISLAND BLOSSOMS HOME CARE LLC
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1830 N BUFFALO DR UNIT 2012
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City | LAS VEGAS
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State | NV
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Zip | 89128-2781
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Country | US
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Telephone | 702-366-5219
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 N BUFFALO DR UNIT 2012
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City | LAS VEGAS
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State | NV
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Zip | 89128-2781
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Country | US
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Telephone | 702-366-5219
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REJETTA DODD-CASTRO
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Credential |
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Telephone | 702-366-5219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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