# CHERRY BLOSSOM CARE AGENCY, INC

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

## Provider details

- **NPI number:** 1124271267
- **Authorized official:** MS. DENA MARIE GREEN (CHIEF OF OPERATIONS)
- **Authorized official phone:** (318) 336-7545

## Contact information

- **Practice address:** 4006 CARTER STREET, VIDALIA, LA 71373-3013
- **Practice address phone:** (318) 336-7545
- **Practice address fax:** (318) 336-7544
- **Mailing address:** 4006 CARTER STREET, VIDALIA, LA 71373-3013
- **Mailing address phone:** (318) 336-7545
- **Mailing address fax:** (318) 336-7544

## Taxonomy

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

## Other

- **Enumeration date:** 11/03/2008
- **Last updated:** 11/03/2008