# BLOSSOM LIGHT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blossom Light Care LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164251690
- **Authorized official:** LYDIA MUSIBE NYETMOR (ADMINISTRATOR)
- **Authorized official phone:** (214) 430-0428

## Contact information

- **Practice address:** 310 W PLEASANT RUN RD, LANCASTER, TX 75146-1566
- **Practice address phone:** (214) 430-0428
- **Mailing address:** 310 W PLEASANT RUN RD, LANCASTER, TX 75146-1566
- **Mailing address phone:** (214) 430-0428

## Taxonomy

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

## Other

- **Enumeration date:** 08/01/2024
- **Last updated:** 08/01/2024