Provider Demographics
NPI:1790008266
Name:SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type:Organization
Organization Name:SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Other - Org Name:SHIAWASSEE HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL SERVICES SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-723-0732
Mailing Address - Street 1:1555 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9775
Mailing Address - Country:US
Mailing Address - Phone:989-723-6791
Mailing Address - Fax:
Practice Address - Street 1:1555 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9775
Practice Address - Country:US
Practice Address - Phone:989-723-6791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-11
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)