Provider Demographics
NPI:1851095467
Name:MI WELLBEING LLC
Entity Type:Organization
Organization Name:MI WELLBEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ORGANIZER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KHAMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-916-6037
Mailing Address - Street 1:549 PRESIDIO BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-1129
Mailing Address - Country:US
Mailing Address - Phone:248-916-6037
Mailing Address - Fax:
Practice Address - Street 1:31701 PLYMOUTH RD.
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1936
Practice Address - Country:US
Practice Address - Phone:248-916-6037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty