Provider Demographics
NPI:1275744948
Name:ALTERNATIVE HEALTH & REHAB CENTRE, PLLC
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH & REHAB CENTRE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:BENN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-235-5181
Mailing Address - Street 1:2284 S BALLENGER HWY
Mailing Address - Street 2:STE F
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-3446
Mailing Address - Country:US
Mailing Address - Phone:810-235-5181
Mailing Address - Fax:810-235-5190
Practice Address - Street 1:2284 S BALLENGER HWY
Practice Address - Street 2:STE F
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3446
Practice Address - Country:US
Practice Address - Phone:810-235-5181
Practice Address - Fax:810-235-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004346261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2301004346OtherSTATE LICENSE NUMBER
MI0B55084Medicare ID - Type UnspecifiedMEDICARE #