Healthcare Provider Details
I. General information
NPI: 1811020035
Provider Name (Legal Business Name): METROPOLITAN REHABILITATION CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20820 GREENFIELD RD STE 100
OAK PARK MI
48237-3051
US
IV. Provider business mailing address
20820 GREENFIELD RD STE 100
OAK PARK MI
48237-3051
US
V. Phone/Fax
- Phone: 248-967-4310
- Fax: 248-967-4301
- Phone: 248-967-4310
- Fax: 248-967-4301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 630417 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 630417 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | 630417 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | 4301037643 |
| License Number State | MI |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | 630417 |
| License Number State | MI |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 6804086872 |
| License Number State | MI |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 630417 |
| License Number State | MI |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | 630417 |
| License Number State | MI |
VIII. Authorized Official
Name:
AMMAR
MEHDI
KHAN
Title or Position: PRESIDENT
Credential: JD
Phone: 248-967-4310