MEDICARE: CENTRAL REHABILITATION, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	208D00000X	General Practice Physician
3	224Z00000X	Occupational Therapy Assistant
4	235Z00000X	Speech-Language Pathologist
5	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1568678324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	20245 W 12 MILE RD
Second Line	:	STE 100
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-5409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20245 W 12 MILE RD
Second Line	:	STE 123
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-5409
Country	:	US
Telephone Number	:	248-569-5410
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHALINI WALVEKAR
Credential	:
Telephone Number	:	248-569-5410

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	10/26/2012

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