MEDICARE: A PLUS BLOSSOM HOME CARE,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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1437725322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PLUS BLOSSOM HOME CARE,LLC

Provider Business Mailing Address
First Line	:	5438 E LAS PIEDRAS WAY
Second Line	:
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331-2415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5438 E LAS PIEDRAS WAY
Second Line	:
City	:	CAVE CREEK
State	:	AZ
Zip	:	85331-2415
Country	:	US
Telephone Number	:	602-370-4790
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. RYAN SAMUEL SIMPSON
Credential	:	N/A
Telephone Number	:	602-570-1111

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/01/2021

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