Provider Demographics
NPI:1598760795
Name:MOTT CHILDREN'S HEALTH CENTER
Entity Type:Organization
Organization Name:MOTT CHILDREN'S HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-237-7570
Mailing Address - Street 1:806 TUURI PL
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2465
Mailing Address - Country:US
Mailing Address - Phone:810-767-5750
Mailing Address - Fax:810-237-7582
Practice Address - Street 1:806 TUURI PL
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2465
Practice Address - Country:US
Practice Address - Phone:810-767-5750
Practice Address - Fax:810-237-7582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty