Blossom Support Coordination LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BLOSSOM SUPPORT COORDINATION LLC

Doing business as

Blossom Support Coordination

Practice address

9800 Airline Hwy Ste 253
Baton Rouge, LA 70816-8006

Phone

(225) 409-7390

Fax

(225) 250-1514

NPI assigned

Mar 21, 2022

Last updated

Jun 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tori Guillory

Title

Executive Director

Phone

(225) 409-7390

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Blossom Support Coordination Doing business as

Tax ID family

Blossom Sca2 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.

• Blossom Support Coordination LLC

  dba Blossom SCA

  • Case Management Agency
  • Baton Rouge, LA
  • NPI 1023868247
  NPD tax ID

Locations

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1598414393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 AIRLINE HWY STE 107",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168000",
            "telephone_number": "225-409-7390",
            "fax_number": "225-250-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 AIRLINE HWY STE 253",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168006",
            "telephone_number": "225-409-7390",
            "fax_number": "225-250-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM SUPPORT COORDINATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-21",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "GUILLORY",
        "authorized_official_first_name": "TORI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-409-7390"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2651315",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2570781",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom Support Coordination",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blossom Support Coordination",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Blocker, PHD, LP
• Wesley C. Blocker, MD
• Christopher J Bloise
• Bloom Collective Healing LLC
• Blossom Support Coordination LLC (Blossom SCA)
• Elizabeth Blough, PA-C
• Amy Katharine Blouin, N.P.
• Taylor Danielle Blouin, BA, SCABA
• Tricia Blouin, BCABA
• Lloyd Matthew Bluain III, PLPC

• Case Management Agency in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Case Management Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.