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Organization
GENESEE COUNTY COMMUNITY MENTAL HEALTH
Active
Organization
GENESEE COUNTY COMMUNITY MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKIYAH JACKSON TLLP (PSYCHOLOGIST)
(810) 596-5348
Entity
Organization
Contact information
Practice address
420 W 5TH AVE, FLINT, MI 48503-2445
(810) 257-3700
Mailing address
420 W 5TH AVE, FLINT, MI 48503-2445
(810) 257-3700
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
6301014667
MI
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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