Provider Demographics
NPI:1497136188
Name:GENESYS AMBULATORY HEATH SERVICES
Entity Type:Organization
Organization Name:GENESYS AMBULATORY HEATH SERVICES
Other - Org Name:GENESYS PACE OF GENESEE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-236-7500
Mailing Address - Street 1:412 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1901
Mailing Address - Country:US
Mailing Address - Phone:810-236-7500
Mailing Address - Fax:
Practice Address - Street 1:412 E 1ST ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1901
Practice Address - Country:US
Practice Address - Phone:810-236-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization