| Blossom Services, Pllc | |
|
25 Clydean Dr Leburn KY 41831-8702 | |
| (606) 216-5431 | |
| Not Available |
| Full Name | Blossom Services, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 25 Clydean Dr, Leburn, Kentucky |
| Authorized Official Name and Position | Jeffrey Combs (OWNER) |
| Authorized Official Contact | 6062165431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Services, Pllc 1192 Pigeonroost Rd Bulan KY 41722-9027 Ph: (606) 216-5431 | Blossom Services, Pllc 25 Clydean Dr Leburn KY 41831-8702 Ph: (606) 216-5431 |
| NPI Number | 1699554006 |
|---|---|
| Provider Enumeration Date | 09/25/2023 |
| Last Update Date | 09/25/2023 |
| Certification Date | 09/25/2023 |
| Medicare PECOS PAC ID | 0749628188 |
|---|---|
| Medicare Enrollment ID | O20240404002780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699554006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Combs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689173825 PECOS PAC ID: 1658719091 Enrollment ID: I20240423001318 |
New Leaf Community Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1070 Wiley Fork Rd, Leburn, KY 41831 Phone: 606-438-5920 |