Blossom Adult Day Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091539 Issued in MI

Legal business name

BLOSSOM ADULT DAY CENTER LLC

Practice address

31023 Birchlawn St
Garden City, MI 48135-1995

Phone

(734) 237-4226

NPI assigned

Jul 5, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ekoyata Ulinfun

Title

Administrator

Phone

(734) 237-4226

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499212800000",
    "number": "1922529478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31023 BIRCHLAWN ST",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351995",
            "telephone_number": "734-237-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31023 BIRCHLAWN ST",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351995",
            "telephone_number": "734-237-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM ADULT DAY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2017-07-05",
        "status": "A",
        "authorized_official_last_name": "ULINFUN",
        "authorized_official_first_name": "EKOYATA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "734-237-4226"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801091539",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Narasimharaju L Bhupathiraju, M.D.
• Lauren Black
• Amanda Christine Blair, D.O.
• Shyla Blanding
• Belal Bleibel
• Gajendra Siva Krishna Pavan Kumar Bobbadi, M.D.
• Jordan Omarion Bolden
• David Nicholas Bomgaars, M.D.
• Christopher Paul Bondick, DO
• Caitlin Boyle

• Clinical Social Worker in Garden City, MI
• Providers in Garden City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.