| Mi Independent Living Llc | |
|
1526 N Mitchell St Cadillac MI 49601-1131 | |
| (231) 942-2091 | |
| Not Available |
| Full Name | Mi Independent Living Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1526 N Mitchell St, Cadillac, Michigan |
| Authorized Official Name and Position | Christopher L Thetford (OWNER) |
| Authorized Official Contact | 2319422091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mi Independent Living Llc 17330 Honor Hwy Lot 1 Interlochen MI 49643-9226 Ph: (231) 942-2091 | Mi Independent Living Llc 1526 N Mitchell St Cadillac MI 49601-1131 Ph: (231) 942-2091 |
| NPI Number | 1093548182 |
|---|---|
| Provider Enumeration Date | 08/23/2024 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093548182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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