NPIMap

Organization Active NPI

Momentum Rehab LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dexter, MI
National Provider Identifier
1295125250
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
6301006431 Issued in MI
Legal business name
MOMENTUM REHAB LLC
Practice address
7926 Ann Arbor St
Dexter, MI 48130-1344
Phone
(734) 320-2497
NPI assigned
Jan 29, 2015
Last updated
Jan 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Authorized official

Name
Dr. Terry L Braciszewski, PH.D.NPI 1386656023
Title
Director
Phone
(734) 320-2497

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 6301006431 MI Primary

Addresses

Primary practice location

7926 Ann Arbor St
Dexter, MI 48130-1344

Mailing address

8838 Hendricks Dr
Brighton, MI 48116-9111
Phone (734) 320-2497

National Provider Directory

National Provider Directory

Locations

7926 Ann Arbor St
Dexter, MI 48130
Phone (734) 320-2497

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1295125250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8838 HENDRICKS DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169111",
            "telephone_number": "734-320-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 ANN ARBOR ST",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301344",
            "telephone_number": "734-320-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "BRACISZEWSKI",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-320-2497",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": "6301006431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.