MEDICARE: CENTRAL REHABILITATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center		MI

General Provider Information

NPI Number	:	1265439483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	28600 SOUTHFIELD RD
Second Line	:	STE 200
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-2745
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28600 SOUTHFIELD RD
Second Line	:	STE 200
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-2745
Country	:	US
Telephone Number	:	248-569-5410
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. SHEEL WALVEKAR
Credential	:	DPT
Telephone Number	:	248-569-5410

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	08/22/2020

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