NPIMap

Organization Active NPI

Flint Odyssey House, Inc.

  • Community/Behavioral Health Agency
  • Port Huron, MI
National Provider Identifier
1194112771
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
SA0250303 Issued in MI
Legal business name
FLINT ODYSSEY HOUSE, INC.
Practice address
1431 Lapeer Ave
Port Huron, MI 48060-4277
Phone
(810) 238-7226
NPI assigned
Apr 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kimberly Meg Shewmaker, LMSW, CAADC, CCDP-D,
Title
Administrative Director
Phone
(810) 238-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X SA0250303 MI Primary

Addresses

Primary practice location

1431 Lapeer Ave
Port Huron, MI 48060-4277

Mailing address

529 Martin Luther King Jr Ave
Flint, MI 48502
Phone (810) 238-7226

National Provider Directory

National Provider Directory
Tax ID family
Flint Odyssey House Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

1431 Lapeer Ave
Port Huron, MI 48060
Phone (810) 479-9138

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1194112771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 MARTIN LUTHER KING JR AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48502",
            "telephone_number": "810-238-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 LAPEER AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604277",
            "telephone_number": "810-238-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLINT ODYSSEY HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "SHEWMAKER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MEG",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "810-238-7226",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW, CAADC, CCDP-D,"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "SA0250303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.