Provider Demographics
NPI:1588963599
Name:GENESEE COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:GENESEE COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:VALACAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-257-3588
Mailing Address - Street 1:630 S SAGINAW ST
Mailing Address - Street 2:ATTN: ACCOUNTING DEPARTMENT SUITE 4
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1525
Mailing Address - Country:US
Mailing Address - Phone:810-237-6167
Mailing Address - Fax:
Practice Address - Street 1:630 S SAGINAW ST
Practice Address - Street 2:ATTN: ACCOUNTING DEPARTMENT SUITE 4
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1525
Practice Address - Country:US
Practice Address - Phone:810-237-6167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility