Provider Demographics
NPI:1508538158
Name:TEAM REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:TEAM REHABILITATION SERVICES, LLC
Other - Org Name:TEAM REHABILITATION - GA
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-282-7757
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:
Practice Address - Street 1:1401 JOHNSON FERRY RD STE 340
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6495
Practice Address - Country:US
Practice Address - Phone:404-491-7420
Practice Address - Fax:404-491-7421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEAM REHABILITATION SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-01
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty