Provider Demographics
NPI:1649152778
Name:BEAUTIFUL BLOSSOMS HOME CARE, LLC
Entity type:Organization
Organization Name:BEAUTIFUL BLOSSOMS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANTITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PROSISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-937-0651
Mailing Address - Street 1:7803 MILL RIVER CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9238
Mailing Address - Country:US
Mailing Address - Phone:804-937-0651
Mailing Address - Fax:
Practice Address - Street 1:3906 BEULAH RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-1456
Practice Address - Country:US
Practice Address - Phone:804-937-0651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health