Provider Demographics
NPI:1295965911
Name:THERACARE REHAB LLC
Entity type:Organization
Organization Name:THERACARE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAMU
Authorized Official - Middle Name:
Authorized Official - Last Name:PADMANABHAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:734-658-8482
Mailing Address - Street 1:43607 LANCASTER CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2230
Mailing Address - Country:US
Mailing Address - Phone:517-750-4360
Mailing Address - Fax:734-844-1471
Practice Address - Street 1:7851 SPRING ARBOR RD STE 24
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9503
Practice Address - Country:US
Practice Address - Phone:517-750-4360
Practice Address - Fax:517-750-4364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-15
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit