# BLOSSOM HOME HEALTHCARE, LLC

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

## Provider details

- **NPI number:** 1619450590
- **Authorized official:** RODA HASSAN (COO)
- **Authorized official phone:** (703) 980-2653

## Contact information

- **Practice address:** 46191 WESTLAKE DR STE 101, POTOMAC FALLS, VA 20165-5870
- **Practice address phone:** (571) 313-0209
- **Practice address fax:** (800) 491-6153
- **Mailing address:** 46191 WESTLAKE DR STE 101, POTOMAC FALLS, VA 20165-5870
- **Mailing address phone:** (571) 313-0209
- **Mailing address fax:** (800) 491-6153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO-191931 | VA | Yes |

## Other

- **Enumeration date:** 09/07/2018
- **Last updated:** 07/11/2020