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23D2106133 CLIA NUMBER - FLINT ODYSSEY HOUSE INC

Laboratory Demographics

CLIA Number: 23D2106133

Facility Name: FLINT ODYSSEY HOUSE INC

Facility Address:
529 MARTIN LUTHER KING AVENUE
FLINT, MI
ZIP 48502
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Facility Phone Number: 810 238-0483

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1194112771

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 23D2106133
LAB Type Physician Office
Facility Name FLINT ODYSSEY HOUSE INC
Street 529 MARTIN LUTHER KING AVENUE
City FLINT
State MI
ZIP 48502
Phone 810 238-0483
CertificateType 4
CertificateEffectiveDate 12/11/2023
CertificateExpirationDate 12/10/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024