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Organization

BLOSSUM DEVELOPMENTAL SOLUTIONS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMAL S STEPHENS (CEO)
(856) 383-6253
Entity
Organization

Contact information

Practice address
5016 BERGENLINE AVE UNIT 2, WEST NEW YORK, NJ 07093-5522
(856) 383-6253
Mailing address
5016 BERGENLINE AVE UNIT 2, WEST NEW YORK, NJ 07093-5522
(856) 383-6253

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/26/2025
Last updated
02/26/2025
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