Healthcare Provider Details

I. General information

NPI: 1194648881
Provider Name (Legal Business Name): AGORA CARE OF MICHIGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OTTAWA AVE NW STE 500
GRAND RAPIDS MI
49503-2311
US

IV. Provider business mailing address

1606 HEADWAY CIR STE 9530
AUSTIN TX
78754-5123
US

V. Phone/Fax

Practice location:
  • Phone: 947-230-0593
  • Fax: 866-240-8655
Mailing address:
  • Phone: 947-230-0593
  • Fax: 866-240-8655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KELSEY ANDERSON
Title or Position: CHIEF STRATEGY OFFICER
Credential:
Phone: 947-230-0593