Provider Demographics
NPI:1427056696
Name:TRI-REHAB, INC.
Entity type:Organization
Organization Name:TRI-REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:AT, PTA
Authorized Official - Phone:734-981-1500
Mailing Address - Street 1:45610 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-5072
Mailing Address - Country:US
Mailing Address - Phone:734-981-1500
Mailing Address - Fax:734-981-1515
Practice Address - Street 1:2421 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3043
Practice Address - Country:US
Practice Address - Phone:313-593-1703
Practice Address - Fax:313-593-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30412OtherBCN
MI64126565OtherBC COMPLETE
MI30412OtherBCBSM