Healthcare Provider Details

I. General information

NPI: 1801700174
Provider Name (Legal Business Name): ECLIPSE REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 E GRAND RIVER AVE STE 203
EAST LANSING MI
48823-4988
US

IV. Provider business mailing address

3110 OAKBROOK WAY
BAY CITY MI
48706-4184
US

V. Phone/Fax

Practice location:
  • Phone: 989-992-1367
  • Fax: 989-220-4990
Mailing address:
  • Phone: 989-992-1367
  • Fax: 989-220-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JEFF ADAM NIEVIEROWSKI
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 989-992-1367