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General NPI Number Information
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NPI Number | 1962667113
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Entity Type | Organization
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Legal Business Name | BLOSSOM SERVICES, INC.
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Dates
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Enumeration Date | 07/26/2008
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Last Update Date | 07/26/2008
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Provider Practice Location Address
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Address Line | 14116 PARKER FARM WAY
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City | SILVER SPRING
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State | MD
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Zip | 20906-6325
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Country | US
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Telephone | 240-432-4856
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Fax |
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Provider Business Mailing Address
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Address Line | 14116 PARKER FARM WAY
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City | SILVER SPRING
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State | MD
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Zip | 20906-6325
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Country | US
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Telephone | 240-432-4856
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BLESSING ATOCK NDANG
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Credential |
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Telephone | 240-432-4856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 039527500
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 039527500
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License Number State | DC
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