| Blossum Developmental Solutions, Llc | |
|
5016 Bergenline Ave Unit 2 West New York NJ 07093-5522 | |
| (856) 383-6253 | |
| Not Available |
| Full Name | Blossum Developmental Solutions, Llc |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 5016 Bergenline Ave Unit 2, West New York, New Jersey |
| Authorized Official Name and Position | Jamal S Stephens (CEO) |
| Authorized Official Contact | 8563836253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossum Developmental Solutions, Llc 5016 Bergenline Ave Unit 2 West New York NJ 07093-5522 Ph: (856) 383-6253 | Blossum Developmental Solutions, Llc 5016 Bergenline Ave Unit 2 West New York NJ 07093-5522 Ph: (856) 383-6253 |
| NPI Number | 1003613241 |
|---|---|
| Provider Enumeration Date | 02/26/2025 |
| Last Update Date | 02/26/2025 |
| Certification Date | 02/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003613241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
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