Healthcare Provider Details

I. General information

NPI: 1598746976
Provider Name (Legal Business Name): MCLAREN FLINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S BALLENGER HWY ADMINISTRATION
FLINT MI
48532
US

IV. Provider business mailing address

401 S BALLENGER HWY ADMINISTRATION
FLINT MI
48532-3638
US

V. Phone/Fax

Practice location:
  • Phone: 810-342-4400
  • Fax: 810-342-2428
Mailing address:
  • Phone: 810-342-4400
  • Fax: 810-342-2428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. FRED KORTE
Title or Position: VICE PRESIDENT/CFO
Credential:
Phone: 810-342-2000