Organization
OCTAGON REHAB SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BABLOO CHACKO (ADMINISTRATOR)
(734) 542-3150
Entity
Organization
Contact information
Practice address
42803 SCHOOLCRAFT RD, PLYMOUTH, MI 48170-2697
(734) 542-3150
(734) 542-3661
Mailing address
42803 SCHOOLCRAFT RD, PLYMOUTH, MI 48170-2697
(734) 542-3150
(734) 542-3661
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
23-6822
MI
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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