Provider Demographics
NPI:1477506624
Name:REHABCARE GROUP EAST INC
Entity Type:Organization
Organization Name:REHABCARE GROUP EAST INC
Other - Org Name:REHABCARE AGENCY MI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7300
Mailing Address - Street 1:540 S PARKER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARINE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48039-3593
Mailing Address - Country:US
Mailing Address - Phone:810-765-8110
Mailing Address - Fax:810-765-9811
Practice Address - Street 1:540 S PARKER ST
Practice Address - Street 2:SUITE B
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-3593
Practice Address - Country:US
Practice Address - Phone:810-765-8110
Practice Address - Fax:810-765-9811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4574019Medicaid
MI4574019Medicaid