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Organization
MEDIVEX LLC
Active
Organization
MEDIVEX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HOLTON (SUPERVISOR)
(281) 216-6971
Entity
Organization
Contact information
Practice address
29650 TRAILWOOD DR, WARREN, MI 48092-4699
(281) 216-6971
Mailing address
29650 TRAILWOOD DR, WARREN, MI 48092-4699
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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