Organization
NEULIFE REHABILITATION OF MICHIGAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GLENN KELLEY (CEO)
(502) 558-8312
Entity
Organization
Contact information
Practice address
1409 ALLEN DR STE G, TROY, MI 48083-4003
(586) 300-5866
Mailing address
36975 UTICA RD STE 102, CLINTON TOWNSHIP, MI 48036-1685
(502) 558-8312
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
283X00000X
Rehabilitation Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
12/15/2021
Last updated
04/24/2025
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