Healthcare Provider Details

I. General information

NPI: 1992617310
Provider Name (Legal Business Name): MIDWEST CARE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 BROADMOOR AVE SE STE 104
KENTWOOD MI
49512-3900
US

IV. Provider business mailing address

3940 BROADMOOR AVE SE STE 104
KENTWOOD MI
49512-3900
US

V. Phone/Fax

Practice location:
  • Phone: 616-333-3771
  • Fax: 616-333-3771
Mailing address:
  • Phone: 616-333-3771
  • Fax: 616-333-3771

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: MR. AVI MIGDAL
Title or Position: PRESIDENT / CEO
Credential:
Phone: 616-333-3771