Organization
MICHIGAN AGENCY WITH CHOICE
Active
Parent organization
GUARDIANTRAC L.L.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GUARDIANTRAC L.L.C.
Authorized official
MR. TIMOTHY CARMICHAEL CPA (CFO)
(269) 651-4500
Entity
Organization
Contact information
Practice address
215 BROADUS ST, STURGIS, MI 49091-1686
(269) 651-4500
(269) 651-4501
Mailing address
215 BROADUS ST, STURGIS, MI 49091-1686
(269) 651-4500
(269) 651-4501
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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