HEALTH SOURCE REHAB, LLC (NPI# 1134556103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134556103 |
| Entity Type | Organization |
| Organization Name | HEALTH SOURCE REHAB, LLC |
| Practice Address |
4100 E 11 Mile Rd Warren MI 48091-1192 |
| Practice Telephone | 5867572440 |
| Practice Fax Number | 5867572441 |
| Mailing Telephone | 5867572440 |
| Mailing Fax Number | 5867572441 |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |
| Authorized Official Name | MR. AUGUSTO DAYCO (DIRECTOR) |
| Authorized Official Telephone | 5867572440 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
4100 E 11 MILE RD |
| City | WARREN |
| State | MI |
| Zip Code | 48091-1192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548615172 | Amanda Lynn Kelsey | Nurse Practitioner | 21647 Ryan Road, Warren, MI 48091 | 2016-05-02 |
| 1902284474 | Daejana Maldonado | Licensed Practical Nurse | 7519 Toepfer, Warren, MI 48091 | 2015-05-15 |
| 1245637743 | Jerami Roy | Recreation Therapist | 7086 E 9 Mile, Warren, MI 48091 | 2014-11-26 |
| 1265698344 | Amanda Sarah Yousif-mansour | Dentist | 2442 E 10 Mile Road, Warren, MI 48091 | 2008-07-29 |
| 1326171166 | Sunshine Dental Center PC | Dentist | 21761 Ryan Rd, Warren, MI 48091 | 2007-03-13 |
| 1487709630 | Albert Spickers | General Practice | 26193 Meredith Drive, Warren, MI 48091 | 2007-01-25 |
| 1487706859 | Rita Jean Rose | Physician Assistant | 2104 E. 11 Mile Road, Suite 600, Warren, MI 48091 | 2007-01-17 |
| 1790835452 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 2000 Ten Mile Rd., Warren, MI 48091 | 2007-01-12 |
| 1942363759 | Carolyn Joan Sucaet | Physical Therapist | 20952 12 Mile Road, Suite 110, St. Clair Shores, FM 48091 | 2006-12-19 |
| 1013070135 | Mcnichols Xray Clinic PC | Radiology | 21230 Dequindre Road, Southeast Michigan Surgical Hospital, Warren, MI 48091 | 2006-12-19 |
| Find all providers in zip 48091 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540335 | Performance Rehab Specialists LLC | Clinic/Center | 8200 Old 13 Mile Rd Ste 102, Warren, MI 48093-2171 | 2020-02-14 |
| 1770141970 | Genie Physical Therapy, LLC | Clinic/Center | 29230 Ryan Rd Ste D, Warren, MI 48092-4274 | 2019-06-03 |
| 1649742396 | Warren Team Care Physical Therapy LLC | Clinic/Center | 7560 E 9 Mile Rd, Warren, MI 48091-2643 | 2018-12-19 |
| 1932691466 | Faith Physical Therapy LLC | Clinic/Center | 30020 Schoenherr Rd Ste A, Warren, MI 48088-3125 | 2018-05-31 |
| 1609379841 | Atlas Physical Therapy & Rehab LLC | Clinic/Center | 13087 E 11 Mile Rd Ste 100, Warren, MI 48088-4795 | 2018-03-14 |
| 1124401625 | Great Lakes Physical Therapy and Rehabilitation LLC | Clinic/Center | 12434 E 12 Mile Rd Ste 101, Warren, MI 48093-3536 | 2015-07-01 |
| 1003210378 | Orthopedic Physical Therapy and Rehabilitation LLC | Clinic/Center | 27253 Van Dyke Ave, Warren, MI 48093-2858 | 2014-10-15 |
| 1083035067 | Michigan Tri-county Physical Therapy Pllc | Clinic/Center | 28475 Van Dyke Ave, Warren, MI 48093-7132 | 2013-12-18 |
| 1023035912 | Occupational Health Centers of Michigan, P.C. | Clinic/Center | 11569 East Twelve Mile Road, Warren, MI 48093 | 2006-07-16 |
| 1902838394 | Occupational Health Centers of Michigan, P.C. | Clinic/Center | 14061 13 Mile Road, Suite 1, Warren, MI 48088 | 2006-07-07 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.