Organization
BLOSSOM CARE COORDINATION LLC
Active
Other names
Blossom Care Coordination
Organization subpart
No
Provider details
NPI number
Authorized official
SHADY LEE COOK (OWNER)
(907) 598-1660
Entity
Organization
Contact information
Practice address
48375 W. POPPY LANE UNIT B, SOLDOTNA, AK 99669
(907) 598-1660
(907) 885-0020
Mailing address
PO BOX 603, SOLDOTNA, AK 99669
(907) 598-1660
(907) 885-0020
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1737850
—
AK
Enumeration date
04/03/2023
Last updated
07/30/2025
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