| Blossom Psychiatric Services | |
|
9233 Park Meadows Dr # 215 Lone Tree CO 80124-5697 | |
| (970) 549-6875 | |
| Not Available |
| Full Name | Blossom Psychiatric Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 9233 Park Meadows Dr # 215, Lone Tree, Colorado |
| Authorized Official Name and Position | Paul Garraty (OWNER) |
| Authorized Official Contact | 9706407643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Psychiatric Services 4833 Front St Unit B-158 Castle Rock CO 80104-7902 Ph: (970) 549-6875 | Blossom Psychiatric Services 9233 Park Meadows Dr # 215 Lone Tree CO 80124-5697 Ph: (970) 549-6875 |
| NPI Number | 1609524149 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 01/16/2024 |
| Medicare PECOS PAC ID | 6406243534 |
|---|---|
| Medicare Enrollment ID | O20220420001111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609524149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Paul G Garraty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922362201 PECOS PAC ID: 0143477513 Enrollment ID: I20120821000305 |
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