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Organization
GRACE REHAB INC
Active
Organization
GRACE REHAB INC
Active
Other names
Preferred Rehabilitation Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FATMEH NISKAR (OWNER)
(313) 928-0700
Entity
Organization
Contact information
Practice address
15636 SOUTHFIELD RD, ALLEN PARK, MI 48101-2513
(313) 928-0700
(313) 928-0701
Mailing address
15636 SOUTHFIELD RD, ALLEN PARK, MI 48101-2513
(313) 928-0700
(313) 928-0701
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30451
BCBSM
MI
Enumeration date
11/06/2006
Last updated
02/01/2024
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