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General NPI Number Information
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NPI Number | 1346387552
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Entity Type | Organization
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Legal Business Name | HERRICK MEDICAL CENTER REHAB
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 500 E POTTAWATAMIE ST
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City | TECUMSEH
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State | MI
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Zip | 49286-2018
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Country | US
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Telephone | 517-424-3000
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Fax | 517-265-0496
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Provider Business Mailing Address
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Address Line | 500 E POTTAWATAMIE ST
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City | TECUMSEH
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State | MI
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Zip | 49286-2018
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Country | US
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Telephone | 517-424-3000
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Fax | 517-265-0496
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIM JAKACKI
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Credential |
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Telephone | 517-265-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State | MI
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