Healthcare Provider Details

I. General information

NPI: 1619983194
Provider Name (Legal Business Name): COMMUNITY RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ELDON BAKER DR
FLINT MI
48507-1923
US

IV. Provider business mailing address

1110 ELDON BAKER DR
FLINT MI
48507-1923
US

V. Phone/Fax

Practice location:
  • Phone: 810-744-3600
  • Fax:
Mailing address:
  • Phone: 810-744-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number25083
License Number StateMI

VIII. Authorized Official

Name: CHRIS FLORES
Title or Position: CEO
Credential:
Phone: 810-744-3600