| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BLOSSOM MANOR LLC | 1750119939 | 2024-08-11 |
The organization Blossom Manor Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1750119939. Registration indicates Blossom Manor Llc is a provider of services with a specialization in Residential Treatment Facilities, Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities (Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities)
| Address | City / State | Phone / Fax |
|---|---|---|
| 2607 Killdeer Ln | Humble, TX 773961827 | 2815706257 / 8326785119 |
| Code | Practice | License No State |
|---|---|---|
| 320900000X PRIMARY | Residential Treatment Facilities Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Behavioral Health/Substance Abuse/Psychiatry Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities |