Provider Demographics
NPI:1801905443
Name:FRANCRACHEL (U.S.A) L.L.C
Entity type:Organization
Organization Name:FRANCRACHEL (U.S.A) L.L.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TEMITOPE
Authorized Official - Middle Name:OLUWOLE
Authorized Official - Last Name:FATIREGUN
Authorized Official - Suffix:
Authorized Official - Credentials:BSC RPT
Authorized Official - Phone:586-491-5551
Mailing Address - Street 1:17330 NORTHLAND PARK CT
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4318
Mailing Address - Country:US
Mailing Address - Phone:586-491-5551
Mailing Address - Fax:
Practice Address - Street 1:17330 NORTHLAND PARK CT
Practice Address - Street 2:SUITE 205
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4318
Practice Address - Country:US
Practice Address - Phone:586-491-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N83540Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER