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General NPI Number Information
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NPI Number | 1275336539
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Entity Type | Organization
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Legal Business Name | BLOSSOM VIEW INCORPORATED
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 3456 F RD
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City | CLIFTON
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State | CO
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Zip | 81520-8433
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Country | US
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Telephone | 970-434-6707
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Fax | 970-434-9323
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Provider Business Mailing Address
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Address Line | 3456 F RD
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City | CLIFTON
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State | CO
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Zip | 81520-8433
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Country | US
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Telephone | 970-434-6707
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Fax | 970-434-9323
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Authorized Official
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Title or Position | DIRECTOR/PRESIDENT
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Name | MRS. BONNITA WALLACE
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Credential |
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Telephone | 970-434-6707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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