Provider Demographics
NPI:1437327160
Name:ADVANCED REHAB & WELLNESS SERVICES PC
Entity Type:Organization
Organization Name:ADVANCED REHAB & WELLNESS SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAMILKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-316-3724
Mailing Address - Street 1:36021 HAZELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-8214
Mailing Address - Country:US
Mailing Address - Phone:305-316-3724
Mailing Address - Fax:
Practice Address - Street 1:31705 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150
Practice Address - Country:US
Practice Address - Phone:305-316-3724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)