Organization
HICKORY HOLLOW SPECIALIZED RESIDENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAVEN BERTRAM (LICENSEE/DESIGNEE)
(833) 478-9464
Entity
Organization
Contact information
Practice address
6500 HICKORY HOLLOW CT, FLINT, MI 48532-2055
(833) 478-9464
Mailing address
3060 S DYE RD, FLINT, MI 48507-1078
(833) 478-9464
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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