Organization
GENESYS HILLSIDE BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PURNA SURAPANENI M.D. (MEDICAL DIRECTOR)
(810) 424-2400
Entity
Organization
Contact information
Practice address
4396 MEADOWS AVE, GRAND BLANC, MI 48439-8689
(810) 513-2390
(810) 579-7222
Mailing address
4396 MEADOWS AVE, GRAND BLANC, MI 48439-8689
(810) 424-2400
(810) 579-7222
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
6801081184
MI
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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