Provider Demographics
NPI:1437142783
Name:COMPLETE REHAB LLC
Entity Type:Organization
Organization Name:COMPLETE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:RATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-649-3755
Mailing Address - Street 1:1380 COOLIDGE HWY STE L50
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7069
Mailing Address - Country:US
Mailing Address - Phone:248-649-3755
Mailing Address - Fax:
Practice Address - Street 1:16655 15 MILE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035
Practice Address - Country:US
Practice Address - Phone:586-792-0970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
7436128OtherAETNA
236641OtherHAP
30660OtherBCBS MI
30660OtherBCBS MI