Provider Demographics
NPI:1033719331
Name:MICHIGAN HEALTH & REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:MICHIGAN HEALTH & REHABILITATION SERVICES, LLC
Other - Org Name:RIVETUS REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESROSIERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP, QCP
Authorized Official - Phone:248-366-8839
Mailing Address - Street 1:25500 MEADOWBROOK RD STE 255
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2005
Mailing Address - Country:US
Mailing Address - Phone:248-366-8839
Mailing Address - Fax:
Practice Address - Street 1:26900 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-5312
Practice Address - Country:US
Practice Address - Phone:248-350-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty