Organization
BLOSSOM HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAHYE MOHAMED TAKAL (OWNER)
(651) 302-9281
Entity
Organization
Contact information
Practice address
1875 PLAZA DR STE 12C, SAINT PAUL, MN 55122-2613
(651) 302-9281
Mailing address
1875 PLAZA DR STE 12C, SAINT PAUL, MN 55122-2613
(651) 302-9281
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
10/29/2024
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