Healthcare Provider Details

I. General information

NPI: 1528247921
Provider Name (Legal Business Name): STANDISH REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S MAIN ST SUITE G
STANDISH MI
48658-9539
US

IV. Provider business mailing address

PO BOX 1158
STANDISH MI
48658-1158
US

V. Phone/Fax

Practice location:
  • Phone: 989-846-0937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN CHRISTIAN
Title or Position: OFFICE MGR
Credential:
Phone: 989-846-0937