=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588968853
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | US REHAB PROVIDERS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2010
-----------------------------------------------------
Last Update Date | 01/05/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 CROSS CREEK PKWY
-----------------------------------------------------
City | AUBURN HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48326-2774
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-425-5505
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33000 COVINGTON CLUB DR APT 79
-----------------------------------------------------
City | FARMINGTON HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48334-1653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-425-5505
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SURESH NARAYANASAMY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 734-425-5505
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------