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General NPI Number Information
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NPI Number | 1164722336
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Entity Type | Organization
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Legal Business Name | BLOSSOM CARE SERVICES INC
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 9100 SOUTHWEST FWY SUITE 217
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City | HOUSTON
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State | TX
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Zip | 77074-1513
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Country | US
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Telephone | 713-981-9200
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Fax | 713-981-9201
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Provider Business Mailing Address
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Address Line | 9100 SOUTHWEST FWY SUITE 217
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City | HOUSTON
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State | TX
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Zip | 77074-1513
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Country | US
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Telephone | 713-981-9200
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Fax | 713-981-9201
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. BAVAKAN AVETISYAN
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Credential |
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Telephone | 713-981-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | TX
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