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General NPI Number Information
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NPI Number | 1710538905
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Entity Type | Organization
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Legal Business Name | COMPLETE LIFE SERVICES PLC
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | G3500 FLUSHING RD STE 244
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City | FLINT
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State | MI
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Zip | 48504-4257
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Country | US
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Telephone | 813-943-5323
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Fax |
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Provider Business Mailing Address
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Address Line | 11835 SHELL BARK LN
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City | GRAND BLANC
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State | MI
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Zip | 48439-3305
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Country | US
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Telephone | 813-943-5323
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Fax | 810-733-7317
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MR. SEON F THOMPSON
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Credential | LMSW, BCD
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Telephone | 813-943-5323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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