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Organization
BLOSSOM COMMUNITY SERVICES
Active
Organization
BLOSSOM COMMUNITY SERVICES
Active
Other names
blossom community services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE DANIELLE DUNBAR PEER SUPPORT. (CERTIFIED SUBTANCE ABUSE CONSERLOR)
(704) 780-3082
Entity
Organization
Contact information
Practice address
3134 AUTEN AVE, CHARLOTTE, NC 28269-4599
(704) 780-3082
Mailing address
3134 AUTEN AVE, CHARLOTTE, NC 28269-4599
(704) 780-3082
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
225XM0800X
Mental Health Occupational Therapist
—
NULL
225XM0800X
Mental Health Occupational Therapist
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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