Organization
BLOSSOM HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARNESHA BULLOCK (CEO)
(623) 267-4479
Entity
Organization
Contact information
Practice address
11201 N TATUM BLVD STE 300, PHOENIX, AZ 85028-6039
(623) 267-4479
(623) 624-7304
Mailing address
11201 N TATUM BLVD STE 300, PHOENIX, AZ 85028-6039
(623) 267-4479
(623) 624-7304
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/10/2024
Last updated
01/10/2025
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