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General NPI Number Information
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NPI Number | 1245478411
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC REHABILITATION CENTER
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 37775 PEMBROKE AVE
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City | LIVONIA
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State | MI
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Zip | 48152-1053
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Country | US
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Telephone | 734-779-0717
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Fax | 248-540-5992
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Provider Business Mailing Address
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Address Line | 37775 PEMBROKE AVE
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City | LIVONIA
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State | MI
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Zip | 48152-1053
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Country | US
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Telephone | 734-779-0717
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Fax | 248-540-5992
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Authorized Official
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Title or Position | TREASURER
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Name | MR. ERIC WOLFE
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Credential |
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Telephone | 248-723-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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