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Blossom Marshall
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lauderhill, Florida
NPI 1356093223

Blossom Marshall is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Lauderdale Lakes, FL. Blossom Marshall practices in Lauderhill, FL. The NPI Number for Blossom Marshall is 1356093223 and holds a License No. (Florida).

The current practice location address for Blossom Marshall is 8520 Nw 46Th Ct, Lauderhill, FL and can be reached out via phone at 954-572-3135.

Location: 8520 Nw 46Th Ct, Lauderhill, FL, 33311-2714
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356093223
Provider Name
Blossom Marshall
Credential
Provider Entity Type
Individual
Gender
Female
Address
8520 Nw 46Th Ct, Lauderhill, FL, 33311-2714
Phone Number
954-572-3135
Fax Number
Provider Enumeration Date
01/21/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
010610800 05 FL
institution
Provider Business Practice Location Address Details
Address
8520 Nw 46Th Ct
City
Lauderhill
State
Florida
Zip
33351-5425
Phone Number
954-572-3135
Fax Number
person
Provider Business Mailing Address Details
Address
8520 Nw 46Th Ct
City
Lauderhill
State
Florida
Zip
33351-5425
Phone Number
954-572-3135
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
(Florida)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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