Provider Demographics
NPI:1740464262
Name:ST. JOHN NEUROLOGICAL RECOVERY SYSTEMS
Entity type:Organization
Organization Name:ST. JOHN NEUROLOGICAL RECOVERY SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP, CBIS
Authorized Official - Phone:586-582-7825
Mailing Address - Street 1:27450 SCHOENHERR RD
Mailing Address - Street 2:100A
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6683
Mailing Address - Country:US
Mailing Address - Phone:586-582-7825
Mailing Address - Fax:586-582-7826
Practice Address - Street 1:27450 SCHOENHERR RD
Practice Address - Street 2:100A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6683
Practice Address - Country:US
Practice Address - Phone:586-582-7825
Practice Address - Fax:586-582-7826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital