Healthcare Provider Details

I. General information

NPI: 1417642877
Provider Name (Legal Business Name): THE MICHOU CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 CANTON RD
MARIETTA GA
30066-2660
US

IV. Provider business mailing address

3660 CANTON RD
MARIETTA GA
30066-2660
US

V. Phone/Fax

Practice location:
  • Phone: 678-586-1808
  • Fax: 706-993-1345
Mailing address:
  • Phone: 678-586-1808
  • Fax: 706-993-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MYRNA CESAR
Title or Position: DIRECTOR
Credential:
Phone: 678-586-1808