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Organization
BLOSSOM HILL CORPORATION
Active
Organization
BLOSSOM HILL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA MARIE BEULKE (DIRECTOR)
(507) 364-5312
Entity
Organization
Contact information
Practice address
100 OAK AVE SW, MONTGOMERY, MN 56069-1243
(507) 364-5312
(507) 364-5908
Mailing address
100 OAK AVE SW, MONTGOMERY, MN 56069
(507) 364-5312
(507) 364-5908
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1072342-1-HCBS
MN
310400000X
Assisted Living Facility
1072346-1-H
MN
320800000X
Mental Illness Community Based Residential Treatment Facility
1044272-1-AFC
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231653100
—
MN
01
—
953485000
MEDICAL ASSISTANCE
MN
Enumeration date
02/09/2007
Last updated
03/17/2018
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