Provider Demographics
NPI:1811020035
Name:METROPOLITAN REHABILITATION CLINICS, INC.
Entity Type:Organization
Organization Name:METROPOLITAN REHABILITATION CLINICS, INC.
Other - Org Name:MRC INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:MEHDI
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:248-967-4310
Mailing Address - Street 1:PO BOX 221
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-0221
Mailing Address - Country:US
Mailing Address - Phone:248-967-4310
Mailing Address - Fax:248-967-4301
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:SUITE 130
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2581
Practice Address - Country:US
Practice Address - Phone:248-967-4310
Practice Address - Fax:248-967-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI630417101YA0400X, 101YM0800X, 103TA0400X, 261QM0801X, 261QM2800X, 261QR0405X
MI68040868721041C0700X
MI4301037643207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20445OtherBLUE CROSS BLUE SHIELD
MI0P25140Medicare ID - Type Unspecified