Healthcare Provider Details

I. General information

NPI: 1699777987
Provider Name (Legal Business Name): REHABILITATION ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S SHORE DR STE 121
BATTLE CREEK MI
49014-5440
US

IV. Provider business mailing address

601 S. SHORE DR STE 121
BATTLE CREEK MI
49015
US

V. Phone/Fax

Practice location:
  • Phone: 269-963-5934
  • Fax: 269-963-8886
Mailing address:
  • Phone: 269-963-5934
  • Fax: 269-963-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: REBECCA BANASZAK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 269-963-5934