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General NPI Number Information
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NPI Number | 1124300199
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Entity Type | Organization
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Legal Business Name | CENTRIA HOME REHABILITATION
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 41521 W 11 MILE RD
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City | NOVI
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State | MI
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Zip | 48375-1803
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Country | US
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Telephone | 248-299-0030
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Fax | 248-912-1566
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Provider Business Mailing Address
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Address Line | 41521 W 11 MILE RD
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City | NOVI
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State | MI
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Zip | 48375-1803
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Country | US
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Telephone | 248-299-0030
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Fax | 248-912-1566
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Authorized Official
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Title or Position | MANAGER
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Name | CHRISTOPHER WILCOX
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Credential |
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Telephone | 248-299-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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