Provider Demographics
NPI:1124455175
Name:AVON REHABILITATION LLC
Entity type:Organization
Organization Name:AVON REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:BHANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-232-9800
Mailing Address - Street 1:6240 RASHELLE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3938
Mailing Address - Country:US
Mailing Address - Phone:810-232-9800
Mailing Address - Fax:810-232-7710
Practice Address - Street 1:6240 RASHELLE DR STE 103
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3938
Practice Address - Country:US
Practice Address - Phone:810-232-9800
Practice Address - Fax:810-232-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty