Provider Demographics
NPI:1639103831
Name:CORA HEALTH SERVICES INC
Entity Type:Organization
Organization Name:CORA HEALTH SERVICES INC
Other - Org Name:CORA REHABILITATION CLINICS - BURTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-221-6712
Mailing Address - Street 1:1110 SHAWNEE ROAD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805
Mailing Address - Country:US
Mailing Address - Phone:419-221-6712
Mailing Address - Fax:419-222-0507
Practice Address - Street 1:1235 SOUTH CENTER ROAD
Practice Address - Street 2:UNIT 12
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509
Practice Address - Country:US
Practice Address - Phone:810-743-8820
Practice Address - Fax:810-743-5908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORA HEALTH SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2759578OtherHEALTH PLUS
MI5564743OtherAETNA
MI30726OtherBLUE CARE NETWORK
MI5564743OtherAETNA
MI2759578OtherHEALTH PLUS