Healthcare Provider Details

I. General information

NPI: 1932305752
Provider Name (Legal Business Name): REHA'S CARE GIVING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 W WALNUT ST 720 W. WALNUT ST.
KALAMAZOO MI
49007-4904
US

IV. Provider business mailing address

720 W WALNUT ST
KALAMAZOO MI
49007-4904
US

V. Phone/Fax

Practice location:
  • Phone: 269-344-7762
  • Fax: 269-762-6543
Mailing address:
  • Phone: 269-344-7762
  • Fax: 269-762-6543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberAF390251655
License Number StateMI

VIII. Authorized Official

Name: MS. REHA LAFRAN BURRELL
Title or Position: OWNER
Credential:
Phone: 269-344-7762