Provider Demographics
NPI:1881487585
Name:MICAH 6:8, LLC
Entity type:Organization
Organization Name:MICAH 6:8, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-340-6690
Mailing Address - Street 1:989 S MAIN ST STE A-435
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4601
Mailing Address - Country:US
Mailing Address - Phone:928-340-6690
Mailing Address - Fax:
Practice Address - Street 1:225 E SHADOW RDG
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-2841
Practice Address - Country:US
Practice Address - Phone:928-340-6690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICAH 6:8, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care