| Ivyrehab Northern Pt Llc | |
|
138 W Highland Rd Howell MI 48843-2168 | |
| (517) 376-4831 | |
| (517) 376-4833 |
| Full Name | Ivyrehab Northern Pt Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 138 W Highland Rd, Howell, Michigan |
| Authorized Official Name and Position | Michael Rucker (CEO) |
| Authorized Official Contact | 9147778700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivyrehab Northern Pt Llc 1311 Mamaroneck Ave Ste 140 White Plains NY 10605-5224 Ph: (914) 294-4050 | Ivyrehab Northern Pt Llc 138 W Highland Rd Howell MI 48843-2168 Ph: (517) 376-4831 |
| NPI Number | 1770113680 |
|---|---|
| Provider Enumeration Date | 01/20/2020 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770113680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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