Organization
BLOSSOM HILL CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD R GRAY (PRESIDENT)
(440) 635-5567
Entity
Organization
Contact information
Practice address
12496 PRINCETON ROAD, HUNTSBURG, OH 44046-0369
(440) 635-5567
(440) 636-5601
Mailing address
PO BOX 369, 12496 PRINCETON ROAD, HUNTSBURG, OH 44046-0369
(440) 635-5567
(440) 636-5601
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
6360
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321664
—
OH
Enumeration date
10/24/2006
Last updated
08/22/2020
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