Organization
PRIME REHAB SERVICES, INC.
Active
Other names
Prime Rehab Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. QURATULANN MOGHUL-PLEMONS P.T. (ADMINISTRATOR/OWNER)
(248) 681-0854
Entity
Organization
Contact information
Practice address
2590 ELIZABETH LAKE RD, WATERFORD, MI 48328-3314
(248) 681-0854
Mailing address
33341 DEQUINDRE, SUITE C, TROY, MI 48083-4630
(248) 588-1388
(248) 543-5205
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30485
BCBSM
MI
Enumeration date
07/05/2005
Last updated
12/08/2022
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