Provider Demographics
NPI:1407679509
Name:ULTIMATE REHAB CENTER LLC
Entity type:Organization
Organization Name:ULTIMATE REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-234-8617
Mailing Address - Street 1:15565 NORTHLAND DR W STE 208
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5310
Mailing Address - Country:US
Mailing Address - Phone:248-234-8617
Mailing Address - Fax:
Practice Address - Street 1:15565 NORTHLAND DR W STE 208
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5310
Practice Address - Country:US
Practice Address - Phone:248-234-8617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty