Organization
BLOSSOM RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL EIRBY BLACK (CEO)
(251) 643-8885
Entity
Organization
Contact information
Practice address
548 MAIN BLVD, PRICHARD, AL 36610-4048
(251) 643-8885
Mailing address
PO BOX 774, MOBILE, AL 36601-0774
(251) 643-8885
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/31/2014
Last updated
03/31/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up