Provider Demographics
NPI:1164744181
Name:INNOVATIVE REHABILITATION SYSTEMS, INC
Entity Type:Organization
Organization Name:INNOVATIVE REHABILITATION SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CRRN
Authorized Official - Phone:248-952-5444
Mailing Address - Street 1:525 E BIG BEAVER RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1364
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 E BIG BEAVER RD
Practice Address - Street 2:SUITE 203
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1364
Practice Address - Country:US
Practice Address - Phone:248-952-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103TR0400X, 225800000X, 225XN1300X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty