Healthcare Provider Details

I. General information

NPI: 1740464262
Provider Name (Legal Business Name): ST. JOHN NEUROLOGICAL RECOVERY SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27450 SCHOENHERR RD 100A
WARREN MI
48088-6683
US

IV. Provider business mailing address

27450 SCHOENHERR RD 100A
WARREN MI
48088-6683
US

V. Phone/Fax

Practice location:
  • Phone: 586-582-7825
  • Fax: 586-582-7826
Mailing address:
  • Phone: 586-582-7825
  • Fax: 586-582-7826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA SCHWARZBERG
Title or Position: OUTPATIENT MANAGER
Credential: M.S., CCC-SLP, CBIS
Phone: 586-582-7825