Provider Demographics
NPI:1093535734
Name:CALECA, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CALECA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4723
Mailing Address - Country:US
Mailing Address - Phone:989-423-7546
Mailing Address - Fax:
Practice Address - Street 1:3771 N MISSION RD
Practice Address - Street 2:
Practice Address - City:ROSEBUSH
Practice Address - State:MI
Practice Address - Zip Code:48878-8749
Practice Address - Country:US
Practice Address - Phone:989-423-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician