Provider Demographics
NPI:1487763280
Name:MED REHAB SERVI ES INC
Entity type:Organization
Organization Name:MED REHAB SERVI ES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:734-432-1700
Mailing Address - Street 1:37463 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1007
Mailing Address - Country:US
Mailing Address - Phone:734-432-1700
Mailing Address - Fax:734-266-7100
Practice Address - Street 1:37463 SCHOOLCRAFT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1007
Practice Address - Country:US
Practice Address - Phone:734-432-1700
Practice Address - Fax:734-266-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30420OtherBCBS
MI30083OtherBCBS
MI30420OtherBCBS