Organization
BLOSSOM CARE AND BEHAVIORAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAKEELAT A ADEOYE PMHNP-BC (PRESIDENT)
(202) 415-0285
Entity
Organization
Contact information
Practice address
15601 PEACH ORCHARD WAY, BOWIE, MD 20716-1543
(202) 415-0285
Mailing address
15601 PEACH ORCHARD WAY, BOWIE, MD 20716-1543
(202) 415-0285
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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