Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 273Y00000X | Rehabilitation Unit | | 82-0040 | MICHIGAN | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 383404533002 | OTHER | MICHIGAN | G02 CHAMPVA CENTER |
| 2 | 010900 | OTHER | MICHIGAN | E21 CARELINK NETWO |
| 3 | 341420303 | OTHER | MICHIGAN | J23 MEADOWBROOK |
| 4 | 383404533002 | OTHER | MICHIGAN | G03 TRICARE |
| 5 | 23-6530 | MEDICARE ID-TYPE UNSPECIFIED | MICHIGAN | MEDICARE |
| 6 | 383404533002 | OTHER | MICHIGAN | G01 TRI-CARE |
| 7 | 000000001537 | OTHER | MICHIGAN | E04 CAPE HEALTH |
| 8 | 55150 | OTHER | MICHIGAN | H61 TOTAL HLTH CAR |
| 9 | 121143 | OTHER | MICHIGAN | H08 CARE CHOICES HMO |
| 10 | 121143 | OTHER | MICHIGAN | H50 PREFERRED CHOI |
| 11 | 266564000 | OTHER | MICHIGAN | E20 COMM BEHAVIOR |
| 12 | 369003700 | OTHER | MICHIGAN | J52 US DEPT/LABOR |
| 13 | 40 5170433 | MEDICAID | MICHIGAN | |
| 14 | 0726021 | OTHER | MICHIGAN | H71 AETNA HMO |
| 15 | 14599 | OTHER | MICHIGAN | E22 PERSON CENTER |
| 16 | 49882 | OTHER | MICHIGAN | H45 OMNICARE |