Healthcare Provider Details

I. General information

NPI: 1568411023
Provider Name (Legal Business Name): YPSILANTI REHABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6055 RAWSONVILLE RD
VAN BUREN TWP MI
48111-2546
US

IV. Provider business mailing address

6055 RAWSONVILLE RD
VAN BUREN TWP MI
48111-2546
US

V. Phone/Fax

Practice location:
  • Phone: 734-485-4544
  • Fax: 734-485-8125
Mailing address:
  • Phone: 734-485-4544
  • Fax: 734-485-8125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501004671
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501011753
License Number StateMI

VIII. Authorized Official

Name: MR. ABDOULAYE NDAW
Title or Position: PRESIDENT
Credential: PT
Phone: 734-485-4544