HEATHER ODOM (NPI# 1275982175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275982175 |
| Entity Type | Individual |
| Full Name | HEATHER ODOM |
| Practice Address |
1110 Eldon Baker Drive Flint MI 48507 |
| Mailing Address |
1100 Eldon Baker Drive Flint MI 48502 |
| Practice Telephone | 8107423134 |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417275751 | Heather W Odom | Registered Nurse | 222 Tongass Dr, Sitka, AK 99835-9416 | 2010-05-11 |
| Street Address |
1110 ELDON BAKER DRIVE |
| City | FLINT |
| State | MI |
| Zip Code | 48507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952599045 | Crecendra M Brown | Social Worker | 1110 Eldon Baker Drive, Flint, MI 48507 | 2007-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847870 | Alexis Nichole Leach | Physician Assistant | 5494 South Dort Hwy, Flint, MI 48507 | 2020-09-28 |
| 1508330317 | Jeffrey Mark Funck | Registered Nurse | G-4443 Miller Road, Suite 100, Flint, MI 48507 | 2019-01-15 |
| 1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
| 1760984348 | Melissa Dawn Hoffman | Psychologist | 5402 Gateway Centre Drive, Suite B, Flint, MI 48507 | 2018-02-28 |
| 1902327323 | Katee Mast | Case Manager/Care Coordinator | 110 Eldon Baker Drive, Flint, MI 48507 | 2017-07-06 |
| 1699228460 | Joshua Sinclair | Social Worker | 2442 E Maple Ave Ste 207, Flint, MI 48507 | 2016-07-28 |
| 1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
| 1528412822 | Drita Gojcaj | Massage Therapist | 3426 Miller Road, Flint, MI 48507 | 2016-04-22 |
| 1629422100 | Ellen Makarewicz-ely | Massage Therapist | 3426 Miller Rd, Flint, MI 48507 | 2016-04-20 |
| 1700262722 | Katelyn Bailey | Nurse Practitioner | 1420 W Twelfth St, Flint, MI 48507 | 2015-07-31 |
| Find all providers in zip 48507 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579537 | Eden Prairie Residential Care Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 302 Welch Blvd, Flint, MI 48503-1105 | 2019-10-09 |
| 1679010169 | Aim Too Please Home Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3220 Red Barn Rd, Flint, MI 48507-1278 | 2017-01-23 |
| 1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
| 1770859217 | Consumer Advancement | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3209 Old Farm Rd, 4438 Colby Ct., Flint, MI 48507-1248 | 2012-03-29 |
| 1164718441 | Alternative Community Living, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 304 W Tobias St, Flint, MI 48503-3975 | 2011-06-24 |
| 1255576765 | Deshra Michelle Vines | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 714 Lippincott Blvd, Flint, MI 48503-5818 | 2008-12-11 |
| 1598916793 | Royster Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2026 Oren Ave, Flint, MI 48505-4688 | 2008-10-06 |
| 1275740441 | Alternative Community Living, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1921 Colchester Rd, Flint, MI 48503-4676 | 2007-05-17 |
| 1609083872 | Alternative Community Living, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2820 Westwood Pkwy, Flint, MI 48503-4671 | 2007-05-17 |
| 1003842444 | Mayfield Adult Foster Care Home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1113 E Hemphill Rd, Flint, MI 48507-2835 | 2006-06-25 |
| Find all providers in FLINT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.