Organization
BLOSSOM ADULT DAY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EKOYATA ULINFUN (ADMINISTRATOR)
(734) 237-4226
Entity
Organization
Contact information
Practice address
31023 BIRCHLAWN ST, GARDEN CITY, MI 48135-1995
(734) 237-4226
Mailing address
31023 BIRCHLAWN ST, GARDEN CITY, MI 48135-1995
(734) 237-4226
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801091539
MI
1041C0700X
Clinical Social Worker
Primary
6801091539
MI
Other
Enumeration date
07/05/2017
Last updated
07/05/2017
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