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General NPI Number Information
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NPI Number | 1801968219
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Entity Type | Organization
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Legal Business Name | GENESEE COUNTY COMMUNITY MENTAL HEALTH
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 420 W 5TH AVE
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City | FLINT
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State | MI
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Zip | 48503-2445
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Country | US
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Telephone | 810-257-9142
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Fax | 810-233-5925
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Provider Business Mailing Address
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Address Line | 420 W 5TH AVE
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City | FLINT
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State | MI
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Zip | 48503-2445
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Country | US
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Telephone | 810-257-9142
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Fax | 810-233-5925
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Authorized Official
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Title or Position | ACCESS COORDINATOR
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Name | MRS. CAROL S FALKENBERG
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Credential | R.N.
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Telephone | 810-257-9142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 4704190052
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License Number State | MI
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