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Blossom Well — NPI 1750122198, Chicago, IL | NPI Central

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NPI 1750122198

OrganizationActive

Blossom Well

NPI 1750122198 · Early Intervention Provider Agency · Chicago, IL

Provider details

NPI number: 1750122198
Entity type: Organization
Primary specialty: Early Intervention Provider AgencyAgencies
Organization subpart: No
Authorized official: Tiffany Lewis, Owner(708) 632-1090

Specialties & taxonomies

Early Intervention Provider AgencyPrimary252Y00000X
Agencies
Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Interpreter171R00000X
Other Service Providers

Practice location

142 W 62nd St

Chicago, IL 60621-3809

Phone: (708) 632-1090

Approximate (ZIP-level) locationGet directions

More IL providers

Mailing address

4193 W Crestline St

Chicago, IL 60652-2923

Registry dates

Enumerated: 2024-05-31
Last updated: 2024-07-06
Certified: 2024-07-06

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.