Healthcare Provider Details

I. General information

NPI: 1801819149
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF SHIAWASSEE AND GENESEE COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 N M 52 STE 1
OWOSSO MI
48867-1025
US

IV. Provider business mailing address

901 CHIPPEWA ST
FLINT MI
48503-1552
US

V. Phone/Fax

Practice location:
  • Phone: 989-723-8239
  • Fax: 989-723-8230
Mailing address:
  • Phone: 810-232-9950
  • Fax: 810-232-9110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number250095
License Number StateMI

VIII. Authorized Official

Name: CRYSTAL HOMAN
Title or Position: BILLING OPERATIONS MANAGER
Credential:
Phone: 810-232-9950