Blossom Well

LBN: Blossom Well
Blossom Well is an health care organization with primary practice located at 142 W 62Nd St , Chicago IL 60621-3809. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Interpreter, Agencies / Early Intervention Provider Agency. Agencies / Early Intervention Provider Agency is the primary health care specialty. Blossom Well can be contacted via phone (708) 632-1090, or through Lewis, Tiffany via phone (708) 632-1090.

Contact Information

Primary practice address
142 W 62Nd St Chicago IL 60621-3809
Phone: (708) 632-1090
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lewis, Tiffany
Phone: (708) 632-1090

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Other Service Providers / Interpreter 171R00000X
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1750122198
LBN Legal business name Blossom Well
DBA Doing business as
Authorized official Lewis, Tiffany
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2024
Last updated Jul 6th, 2024 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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