BLOSSOM CARE AND BEHAVIORAL SERVICES INC (NPI# 1043834757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043834757 |
| Entity Type | Organization |
| Organization Name | BLOSSOM CARE AND BEHAVIORAL SERVICES INC |
| Practice Address |
15601 Peach Orchard Way Bowie MD 20716-1543 |
| Practice Telephone | 2024150285 |
| Mailing Telephone | 2024150285 |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |
| Authorized Official Name | WAKEELAT A ADEOYE (PRESIDENT) |
| Authorized Official Telephone | 2024150285 |
| Authorized Official Credential | PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15601 PEACH ORCHARD WAY |
| City | BOWIE |
| State | MD |
| Zip Code | 20716-1543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508330903 | Stacey Katheryn Lundquist | Counselor | 3060 Michellville Rd, Suite 106, Bowie, MD 20716 | 2019-01-18 |
| 1427528819 | Nicole Rudd | Counselor | 4315 Northview Dr, Bowie, MD 20716 | 2018-11-28 |
| 1427541838 | Outreach Recovery II, LLC | Internal Medicine | 4201 Northview Dr Ste 104, Bowie, MD 20716 | 2018-06-11 |
| 1487143608 | Fatimata Koroma | Counselor | 3953 Elite St, Bowie, MD 20716 | 2018-05-02 |
| 1043739618 | Breanna Collinson | Behavior Technician | 3017 New Oak Ln., Bowie, MD 20716 | 2017-09-15 |
| 1790202000 | Sierra Williams Howell | Nurse Practitioner | 2802 Eliston Street, Bowie, MD 20716 | 2017-08-28 |
| 1487175105 | Martine Jean | Technician | 15911 Pointer Ridge Rd, Bowie, MD 20716 | 2017-07-03 |
| 1902254493 | Olachi Enwerem | Licensed Practical Nurse | 16206 Audubon Lane, Bowie, MD 20716 | 2016-05-25 |
| 1780039230 | Debra Lachaune Garris | Specialist | 3042 Mitchiville Road, Bowie, MD 20716 | 2016-05-03 |
| 1750782553 | Medical Trasportation Systems LLC | Non-emergency Medical Transport (VAN) | 16036 Elegant Ave, Bowie, MD 20716 | 2014-09-11 |
| Find all providers in zip 20716 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407462559 | Mem Scepter Home & Behavioral | Nurse Practitioner | 14104 Dawn Whistle Way, Bowie, MD 20721-1304 | 2020-09-23 |
| 1427670090 | Asten Nursing and Behavioral Health LLC | Nurse Practitioner | 11400 Belvidere Rd, Bowie, MD 20721-2122 | 2020-05-17 |
| 1366081903 | Abiola Mumuni-abass | Nurse Practitioner | 2600 Ballston Ct, Bowie, MD 20721-3281 | 2019-12-30 |
| 1972140069 | Hightower Behavioral Health | Nurse Practitioner | 4505 Blackbirds Folly Ln, Bowie, MD 20720-5803 | 2019-12-08 |
| 1598316796 | Vera Ngezem | Nurse Practitioner | 15001 Jandleway Ct, Bowie, MD 20721-7299 | 2019-09-28 |
| 1073168449 | Shola Adewunmi | Nurse Practitioner | 14723 London Ln, Bowie, MD 20715-2548 | 2019-08-02 |
| 1740841030 | Aminata Amy Bangura | Nurse Practitioner | 2105 Belfry Ln, Bowie, MD 20721-2253 | 2019-06-26 |
| 1184284424 | Bernardine Okpala | Nurse Practitioner | 5412 Richardsons Endeavor Dr, Bowie, MD 20720-3395 | 2019-06-18 |
| 1659936847 | Meridian Health and Behavioral Services LLC | Nurse Practitioner | 16417 Eves Ct, Bowie, MD 20716-7342 | 2019-05-03 |
| 1831659002 | Ndubuisi Isaac Okoroafor | Nurse Practitioner | 16410 Eddinger Rd, Bowie, MD 20716-6329 | 2019-03-22 |
| Find all providers in BOWIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.