Provider Demographics
NPI:1952498180
Name:ALTERNATIVE REHAB, INC
Entity Type:Organization
Organization Name:ALTERNATIVE REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:RAJU
Authorized Official - Last Name:MANIMALETHU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-476-6080
Mailing Address - Street 1:20319 FARMINGTON RD BLDG E
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1411
Mailing Address - Country:US
Mailing Address - Phone:248-476-8911
Mailing Address - Fax:248-476-8913
Practice Address - Street 1:20319 FARMINGTON RD BLDG E
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1411
Practice Address - Country:US
Practice Address - Phone:248-476-8911
Practice Address - Fax:248-476-8913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007767225100000X
MI5501005163225100000X
MI5501006797225100000X
MI5501006800225100000X
MI5501009887225100000X
MI5501014812225100000X
MI5501014862225100000X
MI5501009312225100000X
MI5201000980225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650H217590OtherOUR BCBS GROUP PIN
MI1023177474OtherNPI OF SAKINA BOHRA
MI1043309966OtherNPI OF TOBY MANIMALETHU
MI1700945235OtherNPI OF DEEPAK SEBASTIAN
MI1932298643OtherNPI OF THOMAS SYRIAC
MI1811056328OtherNPI OF RAMESH MALLADI
MI670H200230OtherSAKINA BOHRA'S BCBS PIN
MI1982786554OtherNPI OF RAGHU CHOVVATH
MI1982786554OtherNPI OF RAGHU CHOVVATH
MI1043309966OtherNPI OF TOBY MANIMALETHU
MI1740578095OtherNPI FOR KISHORE JEEVANANDAM
MI=========OtherOUR TAX ID