Healthcare Provider Details

I. General information

NPI: 1194926758
Provider Name (Legal Business Name): MICHOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 HOGBACK RD SUITE 7
ANN ARBOR MI
48105-9738
US

IV. Provider business mailing address

2004 HOGBACK RD SUITE 7
ANN ARBOR MI
48105-9738
US

V. Phone/Fax

Practice location:
  • Phone: 734-485-0355
  • Fax: 734-485-0355
Mailing address:
  • Phone: 734-485-0355
  • Fax: 734-485-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. IKECHUKWU C ODUM
Title or Position: PRESIDENT
Credential:
Phone: 734-485-0355