NPIMap

Organization Active NPI

Grace Rehab Inc

Doing business as Preferred Rehabilitation Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Allen Park, MI
National Provider Identifier
1215006465
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
GRACE REHAB INC
Doing business as
Preferred Rehabilitation Inc
Practice address
15636 Southfield Rd
Allen Park, MI 48101-2513
Phone
(313) 928-0700
Fax
(313) 928-0701
NPI assigned
Nov 6, 2006
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Mrs. Fatmeh Niskar
Title
Owner
Phone
(313) 928-0700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

15636 Southfield Rd
Allen Park, MI 48101-2513

Mailing address

15636 Southfield Rd
Allen Park, MI 48101-2513
Phone (313) 928-0700

Other identifiers 1

IdentifierTypeStateIssuer
30451OtherMIBCBSM

Other names 1

  • Preferred Rehabilitation Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050322000381 MI Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 3375598428 Practice locations: Allen Park, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215006465. Details of each certification follow.

  • CCN 236688 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 236688

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PREFERRED REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jul 17, 1995
Last certification
May 2, 2019
Ownership / control type
Proprietary
Facility address
15636 Southfield Road
Allen Park, MI 48101

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1215006465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15636 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012513",
            "telephone_number": "313-928-0700",
            "fax_number": "313-928-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15636 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012513",
            "telephone_number": "313-928-0700",
            "fax_number": "313-928-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "NISKAR",
        "authorized_official_first_name": "FATMEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-928-0700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "30451",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preferred Rehabilitation Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Preferred Rehabilitation Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Allen Park, MI

Sources for this page

Verify at the official NPI Registry.