MEDICARE: CC REHAB & HOME CARE SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1083117246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CC REHAB & HOME CARE SERVICES, INC

Provider Business Mailing Address
First Line	:	745 BARCLAY CIR STE 340
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-5811
Country	:	US
Telephone Number	:	248-606-4351
Fax Number	:	248-606-4362

Provider Business Practice Location Address
First Line	:	745 BARCLAY CIR STE 340
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-5811
Country	:	US
Telephone Number	:	248-606-4351
Fax Number	:	248-606-4362

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GRADY TOOMBS
Credential	:	ESQ.
Telephone Number	:	248-606-4351

Provider Enumeration Date	:	03/14/2018
Last Update Date	:	03/14/2018

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