GREAT LAKES PHYSICAL THERAPY AND REHABILITATION LLC (NPI# 1124401625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124401625 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES PHYSICAL THERAPY AND REHABILITATION LLC |
| Practice Address |
12434 E 12 Mile Rd Ste 101 Warren MI 48093-3536 |
| Practice Telephone | 5865789121 |
| Practice Fax Number | 5865789124 |
| Mailing Telephone | 5865789121 |
| Mailing Fax Number | 5865789124 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | MR. DAVID JAMES STAPELS (PRESIDENT) |
| Authorized Official Telephone | 5863214563 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
E6533E | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ADDRESS | 12434 | 01 |
| Street Address |
12434 E 12 MILE RD STE 101 |
| City | WARREN |
| State | MI |
| Zip Code | 48093-3536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| 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 |
| 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 |
| 1134556103 | Health Source Rehab, LLC | Clinic/Center | 4100 E 11 Mile Rd, Warren, MI 48091-1192 | 2013-10-04 |
| 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.