Provider Demographics
NPI:1033411509
Name:MICHIGAN AGENCY WITH CHOICE
Entity Type:Organization
Organization Name:MICHIGAN AGENCY WITH CHOICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:269-651-4500
Mailing Address - Street 1:215 BROADUS ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-1686
Mailing Address - Country:US
Mailing Address - Phone:269-651-4500
Mailing Address - Fax:269-651-4501
Practice Address - Street 1:215 BROADUS ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-1686
Practice Address - Country:US
Practice Address - Phone:269-651-4500
Practice Address - Fax:269-651-4501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUARDIANTRAC L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care