# BLOSSOM HOME CAREL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033847066
- **Authorized official:** LUWIZA MALUNGA (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (678) 992-5556

## Contact information

- **Practice address:** 1613 BUNTING FOREST CT, MARIETTA, GA 30064-2949
- **Practice address phone:** (678) 992-5556
- **Practice address fax:** (678) 992-5556
- **Mailing address:** 1613 BUNTING FOREST CT, MARIETTA, GA 30064-2949
- **Mailing address phone:** (678) 992-5556
- **Mailing address fax:** (678) 992-5556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2022
- **Last updated:** 08/09/2022