Healthcare Provider Details

I. General information

NPI: 1063598522
Provider Name (Legal Business Name): SPECIAL TREE NEURO CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/08/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10909 HANNAN RD
ROMULUS MI
48174-1383
US

IV. Provider business mailing address

10909 HANNAN RD
ROMULUS MI
48174-1383
US

V. Phone/Fax

Practice location:
  • Phone: 734-893-1000
  • Fax: 734-941-7522
Mailing address:
  • Phone: 734-893-1000
  • Fax: 734-941-7522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MEGEN MCDONOUGH
Title or Position: DIRECTOR
Credential:
Phone: 734-893-1094