Provider Demographics
NPI:1386690741
Name:EXCELL REHAB INC
Entity Type:Organization
Organization Name:EXCELL REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MADHUSAGER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHINDRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-772-2076
Mailing Address - Street 1:29111 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081
Mailing Address - Country:US
Mailing Address - Phone:586-772-2076
Mailing Address - Fax:586-772-2076
Practice Address - Street 1:29111 HARPER AVE
Practice Address - Street 2:
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081
Practice Address - Country:US
Practice Address - Phone:586-772-2076
Practice Address - Fax:586-772-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
236828Medicare ID - Type Unspecified