Provider Demographics
NPI:1497001036
Name:WELL-POINT REHAB LLC
Entity Type:Organization
Organization Name:WELL-POINT REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-387-5119
Mailing Address - Street 1:25321 5 MILE RD
Mailing Address - Street 2:STE 2
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3700
Mailing Address - Country:US
Mailing Address - Phone:313-387-4119
Mailing Address - Fax:313-387-5148
Practice Address - Street 1:25321 5 MILE RD
Practice Address - Street 2:STE 2
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3700
Practice Address - Country:US
Practice Address - Phone:313-387-4119
Practice Address - Fax:313-387-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy