Provider Demographics
NPI:1528015336
Name:UNIVERSITY REHABILITATION ALLIANCE, INC.
Entity Type:Organization
Organization Name:UNIVERSITY REHABILITATION ALLIANCE, INC.
Other - Org Name:ORIGAMI REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CBIS
Authorized Official - Phone:517-455-0265
Mailing Address - Street 1:3181 SANDHILL RD.
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854
Mailing Address - Country:US
Mailing Address - Phone:517-336-6060
Mailing Address - Fax:517-336-6050
Practice Address - Street 1:3181 SANDHILL RD.
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854
Practice Address - Country:US
Practice Address - Phone:517-336-6060
Practice Address - Fax:517-336-6050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2081P0301X, 2084P0301X
MIAL330068918311ZA0620X
MIAL30068918311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury MedicineGroup - Multi-Specialty
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury MedicineGroup - Multi-Specialty