Provider Demographics
NPI:1417264573
Name:HIGHER STANDARD THERAPEUTICS REHAB PC
Entity Type:Organization
Organization Name:HIGHER STANDARD THERAPEUTICS REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-445-0991
Mailing Address - Street 1:17563 GREENFIELD RD # A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3100
Mailing Address - Country:US
Mailing Address - Phone:248-445-0991
Mailing Address - Fax:
Practice Address - Street 1:17563 GREENFIELD RD
Practice Address - Street 2:A
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3100
Practice Address - Country:US
Practice Address - Phone:313-491-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI4284Medicare PIN