Provider Demographics
NPI:1801382437
Name:BOARD OF EDUCATION FOR CITY OF FLINT
Entity Type:Organization
Organization Name:BOARD OF EDUCATION FOR CITY OF FLINT
Other - Org Name:WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING/CONTRACTING SPECIALIS
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-875-9186
Mailing Address - Street 1:923 E KEARSLEY ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-1974
Mailing Address - Country:US
Mailing Address - Phone:810-767-6188
Mailing Address - Fax:
Practice Address - Street 1:923 E KEARSLEY ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-1974
Practice Address - Country:US
Practice Address - Phone:810-767-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty