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) 496-4881
(810) 257-3785
Mailing address
1040 W BRISTOL RD, FLINT, MI 48507-5516
(810) 496-4881
(810) 257-3785
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
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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