Blossom Ever-Care Home Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

BLOSSOM EVER-CARE HOME INC

Practice address

4224 Stonewall Dr
Forney, TX 75126-3010

Phone

(214) 487-4007

NPI assigned

May 16, 2024

Last updated

May 16, 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

Solange Matchouabou

Title

Administrator

Phone

(214) 487-4007

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1790534105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 STONEWALL DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751263010",
            "telephone_number": "214-487-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 STONEWALL DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751263010",
            "telephone_number": "214-487-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM EVER-CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "MATCHOUABOU",
        "authorized_official_first_name": "SOLANGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-487-4007"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Forney, TX
• Providers in Forney, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.