Organization
BLOSSOM VIEW NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAOMI WENTZ (BUSINESS MANAGER)
(315) 483-9118
Entity
Organization
Contact information
Practice address
6884 MAPLE AVE, SODUS, NY 14551-9303
(315) 483-9118
(315) 483-9432
Mailing address
6884 MAPLE AVE, SODUS, NY 14551-9303
(315) 483-9118
(315) 483-9432
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
5828301N
NY
314000000X
Skilled Nursing Facility
Primary
5828301N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00997604
—
NY
01
—
5828301N
OPERATING CERTIFICATE #
NY
Enumeration date
05/27/2005
Last updated
08/10/2007
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