Provider Demographics
NPI:1194751677
Name:US REHABILITATION & HEALTH SERVICE INC
Entity type:Organization
Organization Name:US REHABILITATION & HEALTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-840-1697
Mailing Address - Street 1:24901 NORTHWESTERN HWY,
Mailing Address - Street 2:SUITE # 113
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075
Mailing Address - Country:US
Mailing Address - Phone:947-282-8575
Mailing Address - Fax:947-282-8576
Practice Address - Street 1:24901 NORTHWESTERN HWY STE 113
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2200
Practice Address - Country:US
Practice Address - Phone:855-369-9955
Practice Address - Fax:947-282-8576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0400X
MI261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI602432700Medicaid
MI30714OtherBLUE CROSS BLUE SHIELD
MI13468OtherMCARE
MI30714OtherBLUE CROSS BLUE SHIELD