Provider Demographics
NPI:1376101063
Name:HERSHMAN REHAB LLC
Entity Type:Organization
Organization Name:HERSHMAN REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:MAHMOUD
Authorized Official - Last Name:DABAJEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-281-6516
Mailing Address - Street 1:23155 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-7703
Mailing Address - Country:US
Mailing Address - Phone:248-281-6516
Mailing Address - Fax:248-281-6586
Practice Address - Street 1:23155 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-7703
Practice Address - Country:US
Practice Address - Phone:248-281-6516
Practice Address - Fax:248-281-6586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy