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Organization

BLOSSOMS ASSISTED LIVING 1, LLC

Active
Parent organization
BLOSSOMS SUPPORT SERVICES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BLOSSOMS SUPPORT SERVICES LLC
Authorized official
MR. PAUL STURDGESS HAYES (ADMINISTRATOR)
(386) 257-2162
Entity
Organization

Contact information

Practice address
1799 SERENO DR, DAVENPORT, FL 33896-8603
(863) 420-1463
Mailing address
1312 MARDRAKE RD, DAYTONA BEACH, FL 32114-5940
(386) 257-2162
(386) 257-2162

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10287
FL

Other

Enumeration date
04/16/2015
Last updated
04/16/2015
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