Organization
BLOSSOM HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GERTRUDE A KISOB (EXECUTIVE DIRECTOR)
(615) 553-4325
Entity
Organization
Contact information
Practice address
2416 NEWBERRY LN, MOUNT JULIET, TN 37122-7460
(615) 553-4325
(615) 754-6724
Mailing address
2416 NEWBERRY LN, MOUNT JULIET, TN 37122-7460
(615) 553-4325
(615) 754-6724
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
PSS0000000257
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445294
—
TN
Enumeration date
12/09/2009
Last updated
12/09/2009
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