Organization Active NPI

Maple Rehab LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Detroit, MI
National Provider Identifier
1093021784
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
MAPLE REHAB LLC
Practice address
100 W Kirby St
Suite 302
Detroit, MI 48202-4044
Phone
(248) 228-4115
NPI assigned
Aug 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ram Kancharla
Title
Member
Phone
(248) 228-4115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

100 W Kirby St
Suite 302
Detroit, MI 48202-4044

Mailing address

100 W Kirby St
Suite 302
Detroit, MI 48202-4044
Phone (248) 228-4115

National Provider Directory

National Provider Directory

Locations

100 W Kirby St
Ste 302
Detroit, MI 48202
Phone (248) 228-4115

G1071 N Ballenger Hwy
Ste 207B
Flint, MI 48504
Phone (810) 496-4477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1093021784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W KIRBY ST",
            "address_2": "SUITE 302",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024044",
            "telephone_number": "248-228-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W KIRBY ST",
            "address_2": "SUITE 302",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024044",
            "telephone_number": "248-228-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "KANCHARLA",
        "authorized_official_first_name": "RAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-228-4115"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.