Provider Demographics
NPI:1225202476
Name:HURON VALLEY REHAB,LLC
Entity Type:Organization
Organization Name:HURON VALLEY REHAB,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HESSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:248-804-3425
Mailing Address - Street 1:835 GARDENIA AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-4402
Mailing Address - Country:US
Mailing Address - Phone:248-804-3425
Mailing Address - Fax:
Practice Address - Street 1:2530 CROOKS RD STE 3
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-3300
Practice Address - Country:US
Practice Address - Phone:888-202-5474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011585225100000X
MI5201002913225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty