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General NPI Number Information
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NPI Number | 1114768884
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Entity Type | Organization
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Legal Business Name | DELTA FAMILY CLINIC SOUTH P.C
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 1309 S LINDEN RD STE C
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City | FLINT
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State | MI
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Zip | 48532-3443
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Country | US
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Telephone | 810-630-1152
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Fax | 810-630-9107
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Provider Business Mailing Address
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Address Line | 1309 S LINDEN RD STE C
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City | FLINT
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State | MI
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Zip | 48532-3443
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Country | US
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Telephone | 810-630-1152
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Fax | 810-630-9107
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Authorized Official
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Title or Position | MANAGER
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Name | ERIN BRIANNE WILLIAMS
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Credential |
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Telephone | 810-630-1152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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