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General NPI Number Information
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NPI Number | 1326810995
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Entity Type | Organization
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Legal Business Name | BLOSSOM HILL SENIOR LIVING LLC
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 5402 LAUREL RIDGE DR
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City | ALPHARETTA
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State | GA
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Zip | 30005-2606
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Country | US
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Telephone | 773-759-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 5402 LAUREL RIDGE DR
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City | ALPHARETTA
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State | GA
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Zip | 30005-2606
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Country | US
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Telephone | 773-759-5556
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Fax |
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | MELISSA NWOKORIE
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Credential | BSN/RN
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Telephone | 773-759-5556
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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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