NPIMap

Organization Active NPI

Blossom Home Carel, LLC

  • In Home Supportive Care Agency
  • Marietta, GA
National Provider Identifier
1033847066
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
BLOSSOM HOME CAREL, LLC
Practice address
1613 Bunting Forest CT
Marietta, GA 30064-2949
Phone
(678) 992-5556
Fax
(678) 992-5556
NPI assigned
Aug 9, 2022
Last updated
Aug 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Luwiza Malunga
Title
Director of Operations
Phone
(678) 992-5556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

1613 Bunting Forest CT
Marietta, GA 30064-2949

Mailing address

1613 Bunting Forest CT
Marietta, GA 30064-2949
Phone (678) 992-5556

National Provider Directory

National Provider Directory
Tax ID family
Blossom Home Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1033847066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 BUNTING FOREST CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642949",
            "telephone_number": "678-992-5556",
            "fax_number": "678-992-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 BUNTING FOREST CT",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642949",
            "telephone_number": "678-992-5556",
            "fax_number": "678-992-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM HOME CAREL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "MALUNGA",
        "authorized_official_first_name": "LUWIZA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "678-992-5556"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.