Provider Demographics
NPI:1326089178
Name:CENTURY 2 THERAPY FRANKLIN ROAD CENTER, LLC
Entity Type:Organization
Organization Name:CENTURY 2 THERAPY FRANKLIN ROAD CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-381-5880
Mailing Address - Street 1:29200 VASSAR ST
Mailing Address - Street 2:SUITE 535
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2122
Mailing Address - Country:US
Mailing Address - Phone:248-381-5880
Mailing Address - Fax:248-381-5881
Practice Address - Street 1:29200 VASSAR ST
Practice Address - Street 2:SUITE 535
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2122
Practice Address - Country:US
Practice Address - Phone:248-381-5880
Practice Address - Fax:248-381-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
23-4520Medicare ID - Type Unspecified