Provider Demographics
NPI:1063551281
Name:UNIVERSAL REHABILITATION SERVICES INC
Entity type:Organization
Organization Name:UNIVERSAL REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:TAHA
Authorized Official - Last Name:ABULABAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:810-794-8040
Mailing Address - Street 1:26250 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3903
Mailing Address - Country:US
Mailing Address - Phone:810-794-8040
Mailing Address - Fax:810-794-8041
Practice Address - Street 1:26250 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3903
Practice Address - Country:US
Practice Address - Phone:810-794-8040
Practice Address - Fax:810-794-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-05-28
Deactivation Date:2019-02-08
Deactivation Code:
Reactivation Date:2020-05-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236738OtherHAP
MI70723OtherBCBSM
MI3505788Medicaid
MI236738OtherHAP