Blossom View Nursing Home, Inc.

Organization Active NPI Skilled Nursing Facility · Sodus, NY

NPI 1366445074 · NPPES record last updated Aug 10, 2007

Key facts

NPI
1366445074
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
5828301N (NY)
Legal business name
BLOSSOM VIEW NURSING HOME, INC.
Practice address
6884 Maple Ave
Sodus, NY 14551-9303
Phone
(315) 483-9118
Fax
(315) 483-9432
NPI assigned
May 27, 2005
Organization subpart
No

Authorized official

Name
Naomi Wentz
Title
Business Manager
Phone
(315) 483-9118

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Blossom View Nursing Home Inc (2 organizations share this tax ID)

Locations

6884 Maple Ave
Sodus Center, NY 14551
Phone (315) 483-9118

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 5828301N NY
Skilled Nursing Facility 314000000X 5828301N NY Yes

Addresses

Primary practice location

6884 Maple Ave
Sodus, NY 14551-9303

Mailing address

6884 Maple Ave
Sodus, NY 14551-9303
Phone (315) 483-9118

Other identifiers

IdentifierTypeStateIssuer
5828301NOtherNYOPERATING CERTIFICATE #
00997604MedicaidNY

Other providers in Sodus, NY

All providers in Sodus, NY · Skilled Nursing Facility in New York

Sources for this page

Verify at the official NPI Registry.