Provider Demographics
NPI:1194875542
Name:SAMARITAN REHAB SERVICES,INC
Entity type:Organization
Organization Name:SAMARITAN REHAB SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SURENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:313-414-6263
Mailing Address - Street 1:38393 CHURCHILL LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3775
Mailing Address - Country:US
Mailing Address - Phone:248-474-0828
Mailing Address - Fax:313-274-1244
Practice Address - Street 1:38393 CHURCHILL LN
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3775
Practice Address - Country:US
Practice Address - Phone:248-474-0828
Practice Address - Fax:313-274-1244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N62920Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPY