Provider Demographics
NPI:1285935536
Name:ESSENTIAL THERAPY AND REHABILITATION SERVICES, INC.
Entity type:Organization
Organization Name:ESSENTIAL THERAPY AND REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RAJNI
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:586-944-7485
Mailing Address - Street 1:840 CRESTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3261
Mailing Address - Country:US
Mailing Address - Phone:586-944-7485
Mailing Address - Fax:
Practice Address - Street 1:14163 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-2191
Practice Address - Country:US
Practice Address - Phone:313-272-3554
Practice Address - Fax:313-272-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation