Provider Demographics
NPI:1881258374
Name:DIVINE CARE REHAB INC
Entity type:Organization
Organization Name:DIVINE CARE REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-980-1776
Mailing Address - Street 1:28157 DEQUINDRE RD STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3046
Mailing Address - Country:US
Mailing Address - Phone:248-434-8478
Mailing Address - Fax:586-314-0525
Practice Address - Street 1:25001 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1762
Practice Address - Country:US
Practice Address - Phone:313-334-6611
Practice Address - Fax:313-447-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy