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General NPI Number Information
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NPI Number | 1316214372
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Entity Type | Organization
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Legal Business Name | GARDEN CITY REHAB
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Dates
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Enumeration Date | 11/18/2011
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 27513 WARREN RD
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City | GARDEN CITY
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State | MI
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Zip | 48135-2253
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Country | US
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Telephone | 734-338-6592
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Fax | 734-338-6622
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Provider Business Mailing Address
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Address Line | 27513 WARREN RD
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City | GARDEN CITY
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State | MI
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Zip | 48135-2253
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Country | US
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Telephone | 734-338-6592
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Fax | 734-338-6622
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Authorized Official
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Title or Position | DIRECTOR
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Name | SAMAR A. GHOSN
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Credential |
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Telephone | 734-338-6592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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