Organization Name: | BLOSSOM VIEW NURSING HOME |
NPI Number: | 1053600841 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARI CARR (MANAGER) |
Mailing Address: | 47 Maple Ave Suite 300 Sodus |
State: | NY US |
Postal Code: | 145511057 |
Phone Number: | 3154832000 |
Fax Number: | 3154836805 |
NPI Enumeration Date: | 04/01/2011 |
NPI Last Update Date: | 04/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | 5828301N |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |