MEDICARE: RENAISSANCE REHABILITATION ASSOCIATES PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	225100000X	Physical Therapist
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist
5	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1477757573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAISSANCE REHABILITATION ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	4460 SWEET CHERRY LN
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49004-3725
Country	:	US
Telephone Number	:	269-377-5594
Fax Number	:	269-344-8991

Provider Business Practice Location Address
First Line	:	4460 SWEET CHERRY LN
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49004-3725
Country	:	US
Telephone Number	:	269-377-5594
Fax Number	:	269-344-8991

Authorized Official
Title or Position	:	CEO
Name	:	JOEL M. PHILLIPS
Credential	:	OTR
Telephone Number	:	269-377-5594

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	09/11/2025

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