Provider Demographics
NPI:1083801948
Name:SUNCARE REHAB, INC.
Entity Type:Organization
Organization Name:SUNCARE REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNDARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PILLAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-443-7400
Mailing Address - Street 1:15565 NORTHLAND DR W
Mailing Address - Street 2:STE 104
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15565 NORTHLAND DR W
Practice Address - Street 2:STE 104
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5303
Practice Address - Country:US
Practice Address - Phone:248-443-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P19520001Medicare PIN