Provider Demographics
NPI:1386995421
Name:COMPASSIONATE CARE REHAB SERVICES LLC
Entity type:Organization
Organization Name:COMPASSIONATE CARE REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WIELECHOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-438-2204
Mailing Address - Street 1:950 CORPORATE OFFICE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-5003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 MAYER RD
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1358
Practice Address - Country:US
Practice Address - Phone:989-652-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation