Healthcare Provider Details

I. General information

NPI: 1679387336
Provider Name (Legal Business Name): AGORA CARE OF MICHIGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 01/29/2025
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: 469-778-4843
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: OMAR ALI
Title or Position: FOUNDER
Credential:
Phone: 469-778-4843