Provider Demographics
NPI:1396832549
Name:GENESEE CARE L.L.C.
Entity Type:Organization
Organization Name:GENESEE CARE L.L.C.
Other - Org Name:THE SURGERY CENTER OF GENESEE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-732-7700
Mailing Address - Street 1:5202 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1040
Mailing Address - Country:US
Mailing Address - Phone:810-732-7700
Mailing Address - Fax:810-733-5840
Practice Address - Street 1:5202 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1040
Practice Address - Country:US
Practice Address - Phone:810-732-7700
Practice Address - Fax:810-733-5840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI256821261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0185138OtherLABOR & INDUSTRY
MIAS250001OtherM-CARE
MI40361OtherBCN OF EAST MICHIGAN
MI0981787OtherHEALTHPLUS OPTIONS
MI1001783OtherMCLAREN HEALTH PLAN
MI40361OtherBCBS OF MICHIGAN
MI5286614OtherAETNA
MI1001783OtherMCLAREN HEALTH ADVANTAGE
MI0981787OtherHEALTHPLUS OF MICHIGAN
MI0981787OtherHEALTHPLUS PARTNERS
MI0981787OtherHEALTHPLUS SENIOR
MI0981787OtherHEALTHPLUS OF MICHIGAN