VIBRA OF SOUTHEASTERN MICHIGAN, LLC (NPI# 1447617915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447617915 |
| Entity Type | Organization |
| Organization Name | VIBRA OF SOUTHEASTERN MICHIGAN, LLC |
| Other Organization Name | VIBRA HOSPITAL OF SOUTHEASTERN MICHIGAN - DMC CAMPUS |
| Practice Address |
261 Mack Ave 7th Floor Detroit MI 48201-2417 |
| Mailing Address |
5 East River Park Place E #460 Fresno CA 93720-1560 |
| Practice Telephone | 3135946000 |
| Practice Fax Number | 3135946171 |
| Mailing Telephone | 5598922500 |
| Mailing Fax Number | 5598922442 |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2018-12-14 |
| Authorized Official Name | MR. CLINT T. FEGAN (SEC/TREAS) |
| Authorized Official Telephone | 7175915700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282N00000X | General Acute Care Hospital | Hospitals | ||
| Y | 282E00000X | Long Term Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Vibra Hospital of Southeastern Michigan - DMC Campus | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134757339 | Vibra of Southeastern Michigan, LLC | Clinical Medical Laboratory | 1307-a Allen Drive, Troy, MI 48083-4010 | 2020-04-01 |
| Street Address |
261 MACK AVE 7TH FLOOR |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225038904 | Scott Richard Millis | Clinical Neuropsychologist | 261 Mack Ave, Rehabilitation Institute of Michigan, Rm 552, Detroit, MI 48201-2417 | 2005-07-26 |
| 1639781057 | Jared Thomas Kurdunowicz | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-4820 | 2020-08-18 |
| 1497373211 | Rachel Smith | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-2495 | 2020-07-08 |
| 1083252340 | Abbey Rae Stuhldreher | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-2417 | 2019-12-18 |
| 1316593452 | Stephanie Hollander | Specialist/Technologist | 261 Mack Ave, Detroit, MI 48201-2417 | 2019-08-14 |
| 1801354147 | Jordan Malik Lawal | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-2417 | 2019-03-06 |
| 1164980553 | Kelsey Ann Vanamberg | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-2417 | 2019-03-05 |
| 1720545262 | Mahtab Koochaki | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-2417 | 2019-02-20 |
| 1760954564 | Courtney Meram | Physical Therapist | 261 Mack Ave, Detroit, MI 48201-2417 | 2018-12-19 |
| 1710457999 | Joyal Dee Pavey | Occupational Therapist | 261 Mack Ave, Detroit, MI 48201-2417 | 2018-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801872379 | Scci Hospitals of America Inc. | Long Term Care Hospital | 4777 East Outer Drive, Detroit, MI 48234-3241 | 2005-12-16 |
| 1205836806 | Select Specialty Hospital - Northwest Detroit Inc | Long Term Care Hospital | 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 | 2005-07-26 |
| 1427564855 | Select Specialty Hospital - Macomb County Inc | Long Term Care Hospital | 22101 Moross Rd, Detroit, MI 48236-2148 | 2017-12-21 |
| 1538426655 | Henry Ford Health System | Long Term Care Hospital | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48101-2608 | 2012-04-13 |
| 1164734547 | Gulcin Altinok | Long Term Care Hospital | 4201 Saint Antoine St, Drh 3l 8, Detroit, MI 48201-2153 | 2010-07-13 |
| 1528259819 | Ltac Hospital Detroit | Long Term Care Hospital | 801 Virginia Park St, Third Floor, Detroit, MI 48202-1925 | 2007-08-05 |
| 1205986411 | St. John Hospital and Medical Center | Long Term Care Hospital | 22101 Moross Rd, Detroit, MI 48236-2148 | 2007-01-11 |
| 1407803810 | Select Specialty Hospital Grosse Pointe Inc | Long Term Care Hospital | 22101 Moross Rd, Detroit, MI 48236-2148 | 2006-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972032209 | Special Care Hospital, LLC | Long Term Care Hospital | 1840 Wealthy St Se Fl 5, Grand Rapids, MI 49506-2921 | 2017-06-09 |
| 1508027624 | Vibra of Southeastern Michigan LLC | Long Term Care Hospital | 26400 West Outer Dr, Lincoln Park, MI 48146-2088 | 2008-06-20 |
| 1962512863 | Mclaren Bay Special Care | Long Term Care Hospital | 3250 E Midland Rd Ste 1, Bay City, MI 48706-2835 | 2006-08-30 |
| 1245230671 | Great Lakes Specialty Hosptial - Hackley LLC | Long Term Care Hospital | 1700 Clinton St, 2 South, 2nd and 3rd Floors, Muskegon, MI 49442-5502 | 2005-07-28 |
| 1912907635 | Select Specialty Hospital - Macomb County Inc | Long Term Care Hospital | 215 North Ave, Mount Clemens, MI 48043-1716 | 2005-07-22 |
| 1912906934 | Select Specialty Hospital - Flint Inc | Long Term Care Hospital | 401 S Ballenger Hwy, Flint, MI 48532-3638 | 2005-07-20 |
| 1225034895 | Select Specialty Hospital - Battle Creek Inc | Long Term Care Hospital | 300 North Ave, Fl 6, Battle Creek, MI 49017-3307 | 2005-06-28 |
| 1508908567 | Spectrum Health United Memorial | Long Term Care Hospital | 615 S Bower St, Greenville, MI 48838-2614 | 2007-02-13 |
| 1609800614 | Great Lakes Specialty Hospital - Oak LLC | Long Term Care Hospital | 200 Jefferson Ave Se, 5th Floor, Grand Rapids, MI 49503-4502 | 2006-07-10 |
| 1295767333 | Lakeland Specialty Hospital At Berrien Center | Long Term Care Hospital | 6418 Deans Hill Rd, Berrien Center, MI 49102-9750 | 2006-07-07 |
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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.