OrganizationBlossom Integrated Health And Behavioral Services LlcNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address338 Mill St, Hagerstown, MD 21740-6138(240) 347-4494PECOS EnrollmentBased on the most recent information from CMS, provider Blossom Integrated Health And Behavioral Services Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:30 PM.Profile DetailsProvider ID1043057722Provider TypeOrganizationFull NameBlossom Integrated Health And Behavioral Services LlcSubpartNoEnumeration Date7/10/2024Last Updated7/10/2024Contact InformationPractice LocationPractice Address338 Mill St, Hagerstown, MD 21740-6138Phone(240) 347-4494FaxUnlisted FaxMailing LocationMailing Address338 Mill St, Hagerstown, MD 21740-6138Phone(240) 347-4494FaxUnlisted FaxAuthorized OfficialNameUdeagha, Ihuoma Marvelous (Ceo)Phone(240) 347-4494Provider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer