Organization
BWC BRIGHTON LLC
Active
Other names
Blossom Children's Center-Brighton
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZIAD KOZA (OWNER)
(248) 860-6212
Entity
Organization
Contact information
Practice address
8175 MOVIE DR, BRIGHTON, MI 48116-7444
(248) 277-3005
(248) 277-3050
Mailing address
8175 MOVIE DR, BRIGHTON, MI 48116-7444
(248) 277-3005
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
12/14/2021
Last updated
11/02/2022
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