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Organization

GENESEE HEALTH SYSTEM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIS RUSSELL (CHIEF EXECUTIVE OFFICER)
(810) 257-3736
Entity
Organization

Contact information

Practice address
1040 W BRISTOL RD, FLINT, MI 48507-5516
(810) 496-5389
(810) 257-3785
Mailing address
1040 W BRISTOL RD, FLINT, MI 48507-5516
(810) 496-5389
(810) 257-3785

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
MI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
11/29/2012
Last updated
06/05/2025
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