# VISITING HOME MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Physical Medicine and Rehabilitation Specialists of Michigan
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568602050
- **Authorized official:** DR. JUVENAL LIPANA CASTILLO MD (MANAGING MEMBER)
- **Authorized official phone:** (269) 350-8463

## Contact information

- **Practice address:** 4239 ISABELLE ST, PORTAGE, MI 49024-1770
- **Practice address phone:** (269) 350-8463
- **Practice address fax:** (269) 382-4808
- **Mailing address:** 9245 AUSTIN DR, PORTAGE, MI 49002-6403
- **Mailing address phone:** (917) 816-4427
- **Mailing address fax:** (269) 382-4808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 4301087182 | MI | Yes |
| 208D00000X | General Practice Physician | 4301087182 | MI | — |

## Other

- **Enumeration date:** 02/24/2009
- **Last updated:** 02/25/2010