Healthcare Provider Details

I. General information

NPI: 1407730211
Provider Name (Legal Business Name): MED CARE REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 19 MILE RD STE A
STERLING HEIGHTS MI
48314-2181
US

IV. Provider business mailing address

318 JOHN R RD # 372
TROY MI
48083-4542
US

V. Phone/Fax

Practice location:
  • Phone: 586-576-7965
  • Fax: 586-510-4921
Mailing address:
  • Phone: 586-476-7965
  • Fax: 586-510-4921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ERICSON VILLANUEVA
Title or Position: OWNER
Credential: PT
Phone: 248-250-4486