# BLOSSOM VIEW NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blossom View Outpatient Therapy Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053600841
- **Authorized official:** CHARI CARR (MANAGER)
- **Authorized official phone:** (315) 483-2000

## Contact information

- **Practice address:** 47 MAPLE AVE, SUITE 300, SODUS, NY 14551-1057
- **Practice address phone:** (315) 483-2000
- **Practice address fax:** (315) 483-6805
- **Mailing address:** 47 MAPLE AVE, SUITE 300, SODUS, NY 14551-1057
- **Mailing address phone:** (315) 483-2000
- **Mailing address fax:** (315) 483-6805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 5828301N | NY | Yes |

## Other

- **Enumeration date:** 04/01/2011
- **Last updated:** 04/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00997604 | — | NY |
| 01 | — | 5828301N | LICENSE | NY |