Provider Demographics
NPI:1841484177
Name:REHABILITATIVE CARE, PC
Entity type:Organization
Organization Name:REHABILITATIVE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-853-2767
Mailing Address - Street 1:3937 PATIENT CARE WAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4287
Mailing Address - Country:US
Mailing Address - Phone:517-853-2767
Mailing Address - Fax:517-853-2988
Practice Address - Street 1:3937 PATIENT CARE WAY
Practice Address - Street 2:SUITE 107
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4287
Practice Address - Country:US
Practice Address - Phone:517-853-2767
Practice Address - Fax:517-853-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRH0121412081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N99820Medicare PIN
MIG58751Medicare UPIN