Provider Demographics
NPI:1255829172
Name:LAHSER HILLS CARE CENTER
Entity Type:Organization
Organization Name:LAHSER HILLS CARE CENTER
Other - Org Name:CHELSEA HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:RACPAN
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-354-3222
Mailing Address - Street 1:25300 LAHSER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-5868
Mailing Address - Country:US
Mailing Address - Phone:248-354-3222
Mailing Address - Fax:248-354-8383
Practice Address - Street 1:25300 LAHSER RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-5868
Practice Address - Country:US
Practice Address - Phone:248-354-3222
Practice Address - Fax:248-354-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========1Medicaid