Healthcare Provider Details

I. General information

NPI: 1346549276
Provider Name (Legal Business Name): FLEX CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24361 GREENFIELD RD
SOUTHFIELD MI
48075-3139
US

IV. Provider business mailing address

18570 CAPITOL DR
SOUTHFIELD MI
48075-2609
US

V. Phone/Fax

Practice location:
  • Phone: 313-737-9750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN HARGROVE
Title or Position: OWNER
Credential:
Phone: 313-737-9750