Provider Demographics
NPI:1548227895
Name:SPECIALIST REHAB SERVICES INC.
Entity Type:Organization
Organization Name:SPECIALIST REHAB SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:248-666-6001
Mailing Address - Street 1:6620 HIGHLAND RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1682
Mailing Address - Country:US
Mailing Address - Phone:248-666-6001
Mailing Address - Fax:248-666-6009
Practice Address - Street 1:6620 HIGHLAND RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1682
Practice Address - Country:US
Practice Address - Phone:248-666-6001
Practice Address - Fax:248-666-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI236799261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236799Medicare PIN
236799Medicare Oscar/Certification