Provider Demographics
NPI:1265784482
Name:COMPLETE REHABILITATION INC
Entity type:Organization
Organization Name:COMPLETE REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARYJO
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFATA
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:248-649-3755
Mailing Address - Street 1:2075 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3407
Mailing Address - Country:US
Mailing Address - Phone:248-649-3755
Mailing Address - Fax:
Practice Address - Street 1:30020 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3125
Practice Address - Country:US
Practice Address - Phone:586-775-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy