Provider Demographics
NPI:1629783402
Name:BALANCE REHAB LLC
Entity Type:Organization
Organization Name:BALANCE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAIYID
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUSSAINI
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:248-667-1877
Mailing Address - Street 1:5785 SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5357
Mailing Address - Country:US
Mailing Address - Phone:248-667-1877
Mailing Address - Fax:
Practice Address - Street 1:5060 VILLA LINDE PKWY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3411
Practice Address - Country:US
Practice Address - Phone:810-733-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicaid