Healthcare Provider Details

I. General information

NPI: 1134634876
Provider Name (Legal Business Name): SAINT PEREGRINE REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 S ISABELLA RD
MOUNT PLEASANT MI
48858-2051
US

IV. Provider business mailing address

2245 S ISABELLA RD
MOUNT PLEASANT MI
48858-2051
US

V. Phone/Fax

Practice location:
  • Phone: 989-400-7466
  • Fax:
Mailing address:
  • Phone: 989-400-7466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROLANDO LUDAN CASIPIT
Title or Position: MANAGER
Credential:
Phone: 989-400-7466