Provider Demographics
NPI:1831345222
Name:STANDARD REHABILITATION SERVICES INC
Entity type:Organization
Organization Name:STANDARD REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DANESHVAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:248-442-2020
Mailing Address - Street 1:33466 W 8 MILE RD STE 222
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5208
Mailing Address - Country:US
Mailing Address - Phone:248-442-2020
Mailing Address - Fax:248-442-8100
Practice Address - Street 1:33466 W 8 MILE RD STE 222
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5208
Practice Address - Country:US
Practice Address - Phone:248-442-2020
Practice Address - Fax:248-442-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30366OtherBCBS PIN
MI236597Medicare PIN