Blossom Manor LLC
Assisted Living Facility in Humble, TX. Organization (NPI-2).
NPI number1548036759
StatusActive
Last updated in NPPESJun 12, 2026
Details
- NPI
- 1548036759
- Entity type
- Organization (NPI-2)
- Legal business name
- Blossom Manor LLC
- Organization subpart
- No
- Enumeration date
- Nov 29, 2023
- Certification date
- Jun 12, 2026
- Last updated
- Jun 12, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – |
Practice location
2607 Killdeer LnHumble, TX 77396-1827
Phone 281-570-6257 · Fax 832-678-5119
Mailing address
3207 Hayden Springs CtHumble, TX 77396-3097
Phone 832-579-4545 · Fax 832-678-5119
Authorized official
Crashonda Rena Dewalt
Program Manager
8325794545
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