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General NPI Number Information
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NPI Number | 1194545509
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Entity Type | Organization
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Legal Business Name | REBOUND SERVICES OF MICHIGAN, INC.
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 16729 EGO
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 248-716-3587
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Fax |
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Provider Business Mailing Address
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Address Line | 23205 GRATIOT AVE # 320
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City | EASTPOINTE
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State | MI
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Zip | 48021-1641
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Country | US
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Telephone | 248-716-3587
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES ANTHONY PRICE
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Credential | LMSW
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Telephone | 248-716-3587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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