Provider Demographics
NPI:1578694808
Name:REHAB ASSOCIATE INC
Entity Type:Organization
Organization Name:REHAB ASSOCIATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SURENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:586-443-5869
Mailing Address - Street 1:21618 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1812
Mailing Address - Country:US
Mailing Address - Phone:586-443-5869
Mailing Address - Fax:586-443-5896
Practice Address - Street 1:21618 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1812
Practice Address - Country:US
Practice Address - Phone:586-443-5869
Practice Address - Fax:586-443-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Not Answered261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236823Medicare ID - Type UnspecifiedREHAB CLINIC