Provider Demographics
NPI:1609285311
Name:GENESSEE COUNTY CMH
Entity Type:Organization
Organization Name:GENESSEE COUNTY CMH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT CASE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:810-257-3705
Mailing Address - Street 1:420 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2445
Mailing Address - Country:US
Mailing Address - Phone:810-257-3705
Mailing Address - Fax:
Practice Address - Street 1:420 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2445
Practice Address - Country:US
Practice Address - Phone:810-257-3705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801097149251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management