Provider Demographics
NPI:1831402684
Name:URBAN HEALTH AND WELLNESS CENTER
Entity type:Organization
Organization Name:URBAN HEALTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW, JD
Authorized Official - Phone:810-424-5366
Mailing Address - Street 1:303 E KEARSLEY ST
Mailing Address - Street 2:1153 WILLIAM S. WHITE BUILDING
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1907
Mailing Address - Country:US
Mailing Address - Phone:810-424-5269
Mailing Address - Fax:810-424-5288
Practice Address - Street 1:303 E KEARSLEY ST
Practice Address - Street 2:1153 WILLIAM S. WHITE BUILDING
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1907
Practice Address - Country:US
Practice Address - Phone:810-424-5269
Practice Address - Fax:810-424-5288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063412261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty