BLOSSOM HILL CORPORATION (NPI# 1932240314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932240314 |
| Entity Type | Organization |
| Organization Name | BLOSSOM HILL CORPORATION |
| Practice Address |
100 Oak Ave Sw Montgomery MN 56069-1243 |
| Mailing Address |
100 Oak Ave Sw Montgomery MN 56069 |
| Practice Telephone | 5073645312 |
| Practice Fax Number | 5073645908 |
| Mailing Telephone | 5073645312 |
| Mailing Fax Number | 5073645908 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MRS. PAULA MARIE BEULKE (DIRECTOR) |
| Authorized Official Telephone | 5073645312 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 1072346-1-H | MN | Nursing & Custodial Care Facilities |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 1044272-1-AFC | MN | Residential Treatment Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1072342-1-HCBS | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICAL ASSISTANCE | 953485000 | 01 |
| MN | 231653100 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1291 9th St Ne, Montgomery, MN 560694303 | 5073645466 | 5073645908 |
| 1317 9th St Ne, Montgomery, MN 560694304 | 5073645050 | 5073645908 |
| 1727 N 5th St, Saint Peter, MN 560821641 | 5079315584 | 5073645908 |
| 301 Juniper Ln Nw, Montgomery, MN 560694444 | 5079530156 | 5073645908 |
| 445 W Derrynane St, Le Center, MN 560571135 | 5073576312 | 5073645908 |
| 505 Deer Trl, Montgomery, MN 560691436 | 5073645980 | 5073645908 |
| Street Address |
100 OAK AVE SW |
| City | MONTGOMERY |
| State | MN |
| Zip Code | 56069-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914392 | Susan Marie Connolly | Counselor | 100 Oak Ave Sw, Montgomery, MN 56069-1243 | 2019-01-02 |
| 1134691975 | Inspire Services, LLC | Clinic/Center | 100 Oak Ave Sw, Montgomery, MN 56069-1243 | 2018-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326108150 | City of Montgomery | Ambulance | 201 Ash Avenue East, Montgomery, MN 56069 | 2006-12-11 |
| 1437139714 | Robert A Taylor | Family Medicine | 501 4th St Nw, Montgomery, MN 56069 | 2006-01-20 |
| 1821495789 | Sara Marie Farias | Nurse Practitioner | 501 4th St Nw, Montgomery, MN 56069-1003 | 2014-11-20 |
| 1992198055 | Brenda Lee Hentges | Licensed Practical Nurse | 407 5th St Nw, Montgomery, MN 56069-1026 | 2015-03-13 |
| 1902430879 | Golden Years Home | Adult Companion | 506 4th St Sw, Montgomery, MN 56069-1222 | 2020-02-28 |
| 1326110388 | Mark Allen Brahs | Dentist | 110 1st St N, Montgomery, MN 56069-1514 | 2006-11-14 |
| 1265086011 | Gabriel Alberto De Los Rios | Dentist | 110 1st St N, Montgomery, MN 56069-1514 | 2019-07-30 |
| 1184087785 | Montgomery Family Dental, Pllc | Dentist | 110 1st St N, Montgomery, MN 56069-1514 | 2016-03-31 |
| 1205217106 | Seth Huiras | Dentist | 110 1st St N, Montgomery, MN 56069-1514 | 2015-06-16 |
| 1417026154 | County of Lesueur | Local Education Agency (LEA) | 101 2nd St Ne, Montgomery, MN 56069-1529 | 2006-11-07 |
| Find all providers in zip 56069 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061307 | Bhg Lxxiii, LLC | Clinic/Center | 1714 Platt Place, Montgomery, AL 36117 | 2020-10-22 |
| 1568986925 | Belfry, LLC | Clinic/Center | 313 S Mcdonough St, Montgomery, AL 36104-4223 | 2017-07-27 |
| 1720404619 | Grace Point Behavioral LLC | Clinic/Center | 8439 Crossland Loop, Montgomery, AL 36117-8485 | 2014-03-15 |
| 1710012398 | Montgomery Area Mental Health Authority Inc | Clinic/Center | 111 Coliseum Blvd, Montgomery, AL 36109-2707 | 2007-02-22 |
| 1144843368 | Kairos Counseling Center, LLC | Clinic/Center | 230 Mendel Pkwy E Ste E, Montgomery, AL 36117-5404 | 2020-05-21 |
| 1134691975 | Inspire Services, LLC | Clinic/Center | 100 Oak Ave Sw, Montgomery, MN 56069-1243 | 2018-12-18 |
| 1528579182 | Fitzpatrick and Watson Counseling, LLC | Clinic/Center | 600 Interstate Park Dr Ste 609, Montgomery, AL 36109-5474 | 2017-10-22 |
| 1174034581 | Serenity Counseling Professionals, LLP | Clinic/Center | 8136 Old Federal Rd, Montgomery, AL 36117-8007 | 2017-10-12 |
| 1205384245 | Nancy W Thomas Counseling Services Pllc | Clinic/Center | 1040 Longfield Ct, Montgomery, AL 36117-8055 | 2016-09-20 |
| 1487829917 | Montgomery Area Mental Health Authority Inc | Clinic/Center | 101 Coliseum Blvd, Montgomery, AL 36109-2707 | 2008-04-25 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 56069 |
Please comment or provide details below to improve the information on BLOSSOM HILL CORPORATION.
| 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.