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General NPI Number Information
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NPI Number | 1235262387
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Entity Type | Organization
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Legal Business Name | SACRED HEART REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 ADAMS ST
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City | BAY CITY
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State | MI
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Zip | 48708-5830
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Country | US
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Telephone | 989-894-2991
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Fax | 989-895-7669
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Provider Business Mailing Address
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Address Line | PO BOX 41038
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City | MEMPHIS
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State | MI
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Zip | 48041-1038
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Country | US
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Telephone | 810-392-2167
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Fax | 810-392-3530
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. GRADY WILKINSON
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Credential |
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Telephone | 810-392-2167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 090073
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License Number State | MI
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