Organization
BLOSSOM HERE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUIANA MESHELL DIXON (PRESIDENT)
(803) 999-3798
Entity
Organization
Contact information
Practice address
101-105 N YORK STREET, LANCASTER, SC 29720-2972
(803) 999-3798
(803) 636-8201
Mailing address
9169 DRAYTON LN, FORT MILL, SC 29707-5848
(201) 852-2309
(201) 852-2309
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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