Provider Demographics
NPI:1386004612
Name:REHABCARE CONNECT PLLC
Entity Type:Organization
Organization Name:REHABCARE CONNECT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MANANSALA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHYSICAL THERAPY
Authorized Official - Phone:248-722-2220
Mailing Address - Street 1:33620 FIVE MILE RD STE A
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2866
Mailing Address - Country:US
Mailing Address - Phone:248-957-8930
Mailing Address - Fax:313-741-1171
Practice Address - Street 1:33620 FIVE MILE RD STE A
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:248-957-8930
Practice Address - Fax:313-741-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty