Organization
BLOSSOM BEHAVIOR CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISDEYBYS BATLLE LORENTE (PRESIDENT)
(786) 523-4289
Entity
Organization
Contact information
Practice address
13706 SW 56TH ST STE 105-106, MIAMI, FL 33175-6036
(786) 688-2630
(786) 513-8495
Mailing address
13706 SW 56TH ST STE 105-106, MIAMI, FL 33175-6036
(786) 688-2630
(786) 513-8495
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/24/2020
Last updated
11/01/2022
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