Provider Demographics
NPI:1851903116
Name:VRC REHABILITATION, LLC
Entity Type:Organization
Organization Name:VRC REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJABHAU
Authorized Official - Middle Name:MAHADEORAO
Authorized Official - Last Name:CHHAPAMOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:989-657-3267
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:HERRON
Mailing Address - State:MI
Mailing Address - Zip Code:49744-0011
Mailing Address - Country:US
Mailing Address - Phone:989-657-3267
Mailing Address - Fax:989-742-2774
Practice Address - Street 1:23525 M 32 W
Practice Address - Street 2:
Practice Address - City:HILLMAN
Practice Address - State:MI
Practice Address - Zip Code:49746-9713
Practice Address - Country:US
Practice Address - Phone:989-742-2773
Practice Address - Fax:989-742-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4361280Medicaid