MEDICARE: REHABILITATION ASSOCIATES, 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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1699777987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATION ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	601 S. SHORE DR
Second Line	:	STE 121
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015
Country	:	US
Telephone Number	:	269-963-5934
Fax Number	:	269-963-8886

Provider Business Practice Location Address
First Line	:	601 S SHORE DR
Second Line	:	STE 121
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-5440
Country	:	US
Telephone Number	:	269-963-5934
Fax Number	:	269-963-8886

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	REBECCA BANASZAK
Credential	:
Telephone Number	:	269-963-5934

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/22/2011

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