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General NPI Number Information
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NPI Number | 1386004612
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Entity Type | Organization
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Legal Business Name | REHABCARE CONNECT PLLC
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 33620 FIVE MILE RD STE A
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City | LIVONIA
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State | MI
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Zip | 48154
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Country | US
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Telephone | 248-957-8930
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Fax | 313-741-1171
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Provider Business Mailing Address
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Address Line | 33620 FIVE MILE RD STE A
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City | LIVONIA
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State | MI
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Zip | 48154-2866
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Country | US
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Telephone | 248-957-8930
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Fax | 313-741-1171
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. JIMMY P MANANSALA JR.
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Credential | PHYSICAL THERAPY
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Telephone | 248-722-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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