# BLOSSOM HERE

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

## Provider details

- **NPI number:** 1730717471
- **Authorized official:** QUIANA MESHELL DIXON (PRESIDENT)
- **Authorized official phone:** (803) 999-3798

## Contact information

- **Practice address:** 101-105 N YORK STREET, LANCASTER, SC 29720-2972
- **Practice address phone:** (803) 999-3798
- **Practice address fax:** (803) 636-8201
- **Mailing address:** 9169 DRAYTON LN, FORT MILL, SC 29707-5848
- **Mailing address phone:** (201) 852-2309
- **Mailing address fax:** (201) 852-2309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/30/2020
- **Last updated:** 03/30/2020