Healthcare Provider Details

I. General information

NPI: 1629981220
Provider Name (Legal Business Name): MID STATE CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36051 FIVE MILE RD
LIVONIA MI
48154-1931
US

IV. Provider business mailing address

37500 PEMBROKE AVE
LIVONIA MI
48152-4061
US

V. Phone/Fax

Practice location:
  • Phone: 734-837-0734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: KEITH MCARTHUR II
Title or Position: PRESIDENT
Credential:
Phone: 734-837-0734