1831568096 NPI number — METROPOLITAN HOUSING DEVELOPMENT CORPORATION

Table of content: DR. LEE WESSON ODESCALCHI PHD (NPI 1942386271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831568096 NPI number — METROPOLITAN HOUSING DEVELOPMENT CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN HOUSING DEVELOPMENT CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831568096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
930 E MYRTLE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48505-5519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-787-9731
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
930 E MYRTLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48505-5519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-787-9731
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2015

Additional Information

Authorized Official

Authorized Official Last Name:
FRANKLIN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
BENJAMIN
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
810-813-0186

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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