Provider Demographics
NPI:1396817771
Name:QUALITY CARE REHABILITATION PROFESSIONALS, INC
Entity Type:Organization
Organization Name:QUALITY CARE REHABILITATION PROFESSIONALS, INC
Other - Org Name:QUALITY CARE REHAB & AUTISM CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TATJANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DHA, OTRL
Authorized Official - Phone:586-286-9644
Mailing Address - Street 1:15023 21 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-5024
Mailing Address - Country:US
Mailing Address - Phone:586-286-9644
Mailing Address - Fax:586-286-9647
Practice Address - Street 1:15023 21 MILE RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315
Practice Address - Country:US
Practice Address - Phone:586-286-9644
Practice Address - Fax:586-286-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201003790174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P27880Medicare PIN
MI0P27900Medicare PIN
MI0P27870Medicare PIN
MI0P27890Medicare PIN