| Blossoming Branch Llc | |
|
1026 Edward St Malvern AR 72104-4426 | |
| (620) 688-1662 | |
| Not Available |
| Full Name | Blossoming Branch Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1026 Edward St, Malvern, Arkansas |
| Authorized Official Name and Position | Shiana Joy Freeman (OWNER/CEO/ADMINISTRATOR) |
| Authorized Official Contact | 6206881662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossoming Branch Llc 1026 Edward St Malvern AR 72104-4426 Ph: (620) 688-1662 | Blossoming Branch Llc 1026 Edward St Malvern AR 72104-4426 Ph: (620) 688-1662 |
| NPI Number | 1982539524 |
|---|---|
| Provider Enumeration Date | 06/15/2026 |
| Last Update Date | 06/15/2026 |
| Certification Date | 06/15/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982539524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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