Provider Demographics
NPI:1477824464
Name:RECLAIM REHABILITATION AND THERAPY, LLC
Entity Type:Organization
Organization Name:RECLAIM REHABILITATION AND THERAPY, LLC
Other - Org Name:RECLAIM REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FREIBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:248-425-6968
Mailing Address - Street 1:515 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1721
Mailing Address - Country:US
Mailing Address - Phone:248-425-6968
Mailing Address - Fax:
Practice Address - Street 1:515 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1721
Practice Address - Country:US
Practice Address - Phone:248-425-6968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty