Provider Demographics
NPI:1568678324
Name:CENTRAL REHABILITATION, INC.
Entity Type:Organization
Organization Name:CENTRAL REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:WALVEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-5410
Mailing Address - Street 1:20245 W 12 MILE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20245 W 12 MILE RD
Practice Address - Street 2:STE 123
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5409
Practice Address - Country:US
Practice Address - Phone:248-569-5410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N96680Medicare ID - Type UnspecifiedMSW GROUP
MI0N96700Medicare ID - Type UnspecifiedPT
MI0N96710Medicare ID - Type UnspecifiedOT
MI0N96690Medicare ID - Type UnspecifiedNMT
MION97620Medicare ID - Type UnspecifiedPHYSICIAN