Blossom Hill, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

36G182 Issued in OH

Legal business name

BLOSSOM HILL, INC.

Doing business as

Haven Hill Home

Practice address

4410 Oakes Rd
Brecksville, OH 44141-2562

Phone

(440) 526-6515

Fax

(440) 526-6615

NPI assigned

Sep 5, 2008

Last updated

Dec 23, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

BLOSSOM HILL INC. CENTER RIDGE HOUSEAs reported in NPPES

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

Authorized official

Name

Gayle Falinski

Title

Ceo

Phone

(440) 892-2042

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Haven Hill Home Doing business as

Tax ID family

Blossom House5 organizations share this tax ID, including this one

Part of

Blossom House

Other organizations with this tax ID 4

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

• Blossom Hill Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Westlake, OH
  • NPI 1588473458
  NPD tax ID
• Blossom Hill Inc.

  dba Center Ridge House

  • Intellectual Disabilities Intermediate Care Facility
  • Westlake, OH
  • NPI 1609085844
  NPD tax ID
• Blossom Hill Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Parma, OH
  • NPI 1861031841
  NPD tax ID
• Blossom House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • N Royalton, OH
  • NPI 1154767606
  NPD tax ID

Locations

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1629226477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10983 ABBEY RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441332537",
            "telephone_number": "440-526-6515",
            "fax_number": "440-526-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 OAKES RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412562",
            "telephone_number": "440-526-6515",
            "fax_number": "440-526-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM HILL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLOSSOM HILL INC. CENTER RIDGE HOUSE",
        "enumeration_date": "2008-09-05",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "FALINSKI",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-892-2042"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "36G182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0570172",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Hill Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haven Hill Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan P Berman, PH.D.
• Ellen Ann Bernard, RN
• Sangeeta S Bhavnani
• Elise Bixenstine
• Kathleen Blasko Stewart, PCC, LICDC, CEAP
• Cheryl Jean Bobo, CMSW
• Rebecca J Bockstoce, OTR
• Steven K Bodey, LISW-S
• Lorrie Christine Boehm, MSSA, LISW
• Carrie Ann Bohenick, MD

• Intellectual Disabilities Intermediate Care Facility in Brecksville, OH
• Providers in Brecksville, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.