1659041721 NPI number — BLOOMING ROSES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659041721 NPI number — BLOOMING ROSES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLOOMING ROSES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BLOOMING ROSES HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659041721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1199 DELBON AVE STE 6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TURLOCK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95382-2006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-226-1342
Provider Business Mailing Address Fax Number:
209-226-1363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1199 DELBON AVE STE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TURLOCK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95382-2006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-226-1342
Provider Business Practice Location Address Fax Number:
209-226-1363
Provider Enumeration Date:
09/20/2021

Additional Information

Authorized Official

Authorized Official Last Name:
YOUSEFIAN
Authorized Official First Name:
ROSE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
209-226-1342

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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