Provider Demographics
NPI:1407803372
Name:ACTION REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:ACTION REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-284-8141
Mailing Address - Street 1:12885 NORTHLINE
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195
Mailing Address - Country:US
Mailing Address - Phone:734-284-8141
Mailing Address - Fax:
Practice Address - Street 1:12885 NORTHLINE
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195
Practice Address - Country:US
Practice Address - Phone:734-284-8141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
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
236825Medicare ID - Type Unspecified