Provider Demographics
NPI:1487686077
Name:REHABILITATION ONE INC
Entity Type:Organization
Organization Name:REHABILITATION ONE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HAANEI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHWEHDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-792-9330
Mailing Address - Street 1:22720 MICHIGAN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2035
Mailing Address - Country:US
Mailing Address - Phone:313-792-9330
Mailing Address - Fax:313-277-7599
Practice Address - Street 1:22720 MICHIGAN AVE STE 103
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2035
Practice Address - Country:US
Practice Address - Phone:313-792-9330
Practice Address - Fax:313-277-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON85630Medicare ID - Type Unspecified