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General NPI Number Information
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NPI Number | 1356296768
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Entity Type | Organization
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Legal Business Name | BLOSSOM TREE HEALTHCARE LLC
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 330 EVERGREEN RD STE 8
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City | LOUISVILLE
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State | KY
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Zip | 40243-1096
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Country | US
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Telephone | 502-418-4629
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Fax | 502-251-4829
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Provider Business Mailing Address
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Address Line | 330 EVERGREEN RD STE 8
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City | LOUISVILLE
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State | KY
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Zip | 40243-1096
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Country | US
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Telephone | 502-418-4629
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Fax | 502-251-4829
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Authorized Official
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Title or Position | MANAGER
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Name | STEPHEN ERIC ASAMOAH
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Credential |
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Telephone | 859-878-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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