Healthcare Provider Details
I. General information
NPI: 1245293117
Provider Name (Legal Business Name): REHABILITATION INSTITUTE INC REHABILITATION INST OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/10/2006
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 MACK AVE
DETROIT MI
48201-2417
US
IV. Provider business mailing address
261 MACK AVE
DETROIT MI
48201-2417
US
V. Phone/Fax
- Phone: 313-578-2357
- Fax: 313-578-3964
- Phone: 313-578-2357
- Fax: 313-578-3964
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 283X00000X |
| Taxonomy | Rehabilitation Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JANE
RUPPMAN
Title or Position: DIRECTOR PM/PA
Credential: DIRECTOR
Phone: 313-578-2357