Healthcare Provider Details

I. General information

NPI: 1417264573
Provider Name (Legal Business Name): HIGHER STANDARD THERAPEUTICS REHAB PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17563 GREENFIELD RD A
DETROIT MI
48235-3100
US

IV. Provider business mailing address

17563 GREENFIELD RD # A
DETROIT MI
48235-3100
US

V. Phone/Fax

Practice location:
  • Phone: 313-491-1300
  • Fax:
Mailing address:
  • Phone: 248-445-0991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LENORE DEAN
Title or Position: OWNER
Credential:
Phone: 248-445-0991