Organization
BLOSSOM SOUTH, LLC
Active
Other names
Blossom South Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD J WOOD (OPERATOR)
(516) 679-1500
Entity
Organization
Contact information
Practice address
1175 MONROE AVE, ROCHESTER, NY 14620-1613
(585) 442-0450
(585) 442-2855
Mailing address
1175 MONROE AVE, ROCHESTER, NY 14620-1613
(585) 442-0450
(585) 442-2855
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2701351N
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355573
—
NY
01
—
183542CI
PREFERRED CARE
NY
Enumeration date
12/18/2006
Last updated
07/19/2007
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