Provider Demographics
NPI:1467855601
Name:MYKALA GROUP LLC
Entity Type:Organization
Organization Name:MYKALA GROUP LLC
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MYKALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-768-0900
Mailing Address - Street 1:744 W MICHIGAN AVE
Mailing Address - Street 2:SUITE 301B
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1900
Mailing Address - Country:US
Mailing Address - Phone:517-768-0900
Mailing Address - Fax:517-768-0909
Practice Address - Street 1:2990 BUSINESS ONE DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-8719
Practice Address - Country:US
Practice Address - Phone:269-762-6110
Practice Address - Fax:269-762-6109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health