Provider Demographics
NPI:1245937242
Name:BLOSSOM BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:BLOSSOM BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NENEH
Authorized Official - Middle Name:BINTA
Authorized Official - Last Name:BARRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-280-2518
Mailing Address - Street 1:100 FRANKLIN SQUARE DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4109
Mailing Address - Country:US
Mailing Address - Phone:908-280-2518
Mailing Address - Fax:
Practice Address - Street 1:100 FRANKLIN SQUARE DR STE 4
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4109
Practice Address - Country:US
Practice Address - Phone:908-280-2518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care