Healthcare Provider Details

I. General information

NPI: 1811070899
Provider Name (Legal Business Name): NEW HORIZONS REHABILITATION SVCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41108 VINCENTI CT
NOVI MI
48375-1922
US

IV. Provider business mailing address

1814 POND RUN
AUBURN HILLS MI
48326-2768
US

V. Phone/Fax

Practice location:
  • Phone: 248-476-6910
  • Fax: 248-476-1380
Mailing address:
  • Phone: 248-340-0559
  • Fax: 248-340-0689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberNP-0006282
License Number StateMI

VIII. Authorized Official

Name: MR. STAN GRAMKE
Title or Position: CEO
Credential:
Phone: 248-340-0559