# BLOSSOM HOME HEALTH CARE AGENCY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912138892
- **Authorized official:** MR. I SHANMUGAVELU (SHAREHOLDER)
- **Authorized official phone:** (734) 981-9146

## Contact information

- **Practice address:** 5820 N LILLEY RD STE 4, CANTON, MI 48187-3686
- **Practice address phone:** (734) 981-9146
- **Practice address fax:** (734) 981-9170
- **Mailing address:** 5820 N LILLEY RD STE 4, CANTON, MI 48187-3686
- **Mailing address phone:** (734) 981-9146
- **Mailing address fax:** (734) 981-9170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/27/2009
- **Last updated:** 05/26/2011