Blossom Creeks Assisted Living 2 Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BLOSSOM CREEKS ASSISTED LIVING 2 INC.

Doing business as

Blossom Creeks Assisted Living 2

Practice address

2770 N Burgan Ave
Fresno, CA 93727-8972

Phone

(559) 598-9515

NPI assigned

Nov 28, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rajvinder K Samra

Title

Ceo

Phone

(559) 598-9515

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Blossom Creeks Assisted Living 2 Doing business as
• Blossom Creeks Assisted Living 2 Inc. Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1013627405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 N BURGAN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937278972",
            "telephone_number": "559-598-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 N BURGAN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937278972",
            "telephone_number": "559-598-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM CREEKS ASSISTED LIVING 2 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "SAMRA",
        "authorized_official_first_name": "RAJVINDER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-598-9515"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497291751",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom Creeks Assisted Living 2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blossom Creeks Assisted Living 2 Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jessica Ann Bloom-Welford
• Taiwo Bloom
• Sheila M Bloomer, M.A., CCC-SLP
• Blossom Care Inc. (Blossom Home Health)
• Blossom Creeks Assisted Living (Rajvinder Samra)
• Blossom Creeks Assisted Living 3 Inc.
• Blossom Growth Family Therapy, Inc
• Blossom Haven, Inc
• Herbert John Blossom, MD
• Blossoming Home Health Care

• Assisted Living Facility in Fresno, CA
• Providers in Fresno, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.