# PORT HURON THERAPY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midwest Therapy Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871546739
- **Authorized official:** MR. MUHAMMAD ZAFAR (PRESIDENT / CEO)
- **Authorized official phone:** (810) 385-9808

## Contact information

- **Practice address:** 34051 GRATIOT AVE, SUITE 103, CLINTON TOWNSHIP, MI 48035-3592
- **Practice address phone:** (810) 385-9808
- **Practice address fax:** (586) 415-7800
- **Mailing address:** 34051 GRATIOT AVE, SUITE 103, CLINTON TOWNSHIP, MI 48035-3592
- **Mailing address phone:** (810) 385-9808
- **Mailing address fax:** (586) 415-7800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | MI | — |
| 385H00000X | Respite Care | — | MI | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 01/30/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 137801 | CARE CHOICES PPO | MI |
| 05 | — | 142585 | — | MI |
| 01 | — | 234528 | HEALTH ALLIANCE PLAN | MI |
| 05 | — | 30322 | — | MI |
| 01 | — | 30426 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 4704356 | — | MI |
| 01 | — | 5135045 | CIGNA PPO | MI |