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Organization

CANTON BCC LLC

Active
Other names
Blossom Children's Center- Canton
Organization subpart
No

Provider details

NPI number
Authorized official
ZIAD KOZA (CEO & FOUNDER)
(248) 277-3005
Entity
Organization

Contact information

Practice address
39453 FORD RD, CANTON, MI 48187-4320
(248) 277-3005
Mailing address
44225 W 12 MILE RD STE C-106, NOVI, MI 48377-2640

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
05/29/2024
Last updated
05/29/2024
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