Provider Demographics
NPI:1275336539
Name:BLOSSOM VIEW INCORPORATED
Entity type:Organization
Organization Name:BLOSSOM VIEW INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-434-6707
Mailing Address - Street 1:3456 F RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520-8433
Mailing Address - Country:US
Mailing Address - Phone:970-434-6707
Mailing Address - Fax:970-434-9323
Practice Address - Street 1:3456 F RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:CO
Practice Address - Zip Code:81520-8433
Practice Address - Country:US
Practice Address - Phone:970-434-6707
Practice Address - Fax:970-434-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility