Organization Name: | PROJECT REHAB |
NPI Number: | 1104986603 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOMMY HOUSE (EXECUTIVE DIRECTION OF PROJECT REHA) |
Mailing Address: | 200 Eastern Ave Se Grand Rapids |
State: | MI US |
Postal Code: | 495034735 |
Phone Number: | 6167760891 |
Fax Number: | 6167769906 |
NPI Enumeration Date: | 12/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 410014 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |