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NPI Code Detail

MEDICARE: BLOSSOM ATRIUM LLC

MEDICARE: BLOSSOM ATRIUM LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1114482098
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOSSOM ATRIUM LLC
Provider Business Mailing Address
First Line : 1382 VINCENZO DR
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08753-2768
Country : US
Telephone Number : 216-906-9465
Fax Number :
Provider Business Practice Location Address
First Line : 9960 ATRIUM WAY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-6487
Country : US
Telephone Number : 904-724-4726
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : BRIAN SCHWARTZ
Credential :
Telephone Number : 216-906-9465
Provider Enumeration Date : 02/05/2019
Last Update Date : 02/05/2019

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Directions to “BLOSSOM ATRIUM LLC ” Practice Location

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