MEDICARE: INTEGRATED DAY SERVICES AND REHABILITATION LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1881233823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED DAY SERVICES AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	627 E 11 MILE RD STE 105
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-1961
Country	:	US
Telephone Number	:	248-850-7628
Fax Number	:

Provider Business Practice Location Address
First Line	:	627 E 11 MILE RD STE 105
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-1961
Country	:	US
Telephone Number	:	248-850-7628
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	WENDY HOOKER
Credential	:
Telephone Number	:	248-850-7628

Provider Enumeration Date	:	12/21/2019
Last Update Date	:	12/21/2019

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