NPIMap

Organization Active NPI

Flint Odyssey House, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Flint, MI
National Provider Identifier
1982128393
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
FLINT ODYSSEY HOUSE, INC.
Practice address
718 Oak St
Flint, MI 48503-2614
Phone
(810) 238-7226
Fax
(810) 239-5518
NPI assigned
Jul 27, 2017
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
Kimberly Meg Shewmaker, LMSW
Title
Director of Program Operations
Phone
(810) 238-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X Primary

Addresses

Primary practice location

718 Oak St
Flint, MI 48503-2614

Mailing address

529 M L King Ave
Flint, MI 48502-2002
Phone (810) 238-7226

Other identifiers 1

IdentifierTypeStateIssuer
2595664MedicaidMI

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

718 Oak St
Flint, MI 48503
Phone (810) 233-8815

Practitioners & affiliated clinicians

Practitioners 3

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": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1982128393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 M L KING AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485022002",
            "telephone_number": "810-238-7226",
            "fax_number": "810-239-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 OAK ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032614",
            "telephone_number": "810-238-7226",
            "fax_number": "810-239-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLINT ODYSSEY HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "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": "DIRECTOR OF PROGRAM OPERATIONS",
        "authorized_official_telephone_number": "810-238-7226",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2595664",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, 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.