Golden Triangle Rehab Inc

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

GOLDEN TRIANGLE REHAB INC

Practice address

28051 Dequindre Rd Ste D
Madison Heights, MI 48071-3016

Phone

(248) 733-5442

Fax

(248) 963-6214

NPI assigned

May 26, 2006

Last updated

Jun 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dina Kamal Asmar

Title

Administrator Owner

Phone

(619) 402-7927

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316993835. Details of each certification follow.

• CCN 236814 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 236814

Legal name

GOLDEN TRIANGLE REHAB

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Oct 8, 2002

Last certification

Jun 30, 2021

Ownership / control type

Proprietary

Facility address

28051 Dequindre Rd, Suite D
Madison Heights, MI 48071

Locations

Practitioners 2

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.

• Renee Talaat Ishak Labib, RPT, CLT

  • Physical Medicine & Rehabilitation Physician
  • Dearborn, MI
  • NPI 1164728937
  NPD (past)
• David Sharath, P.T.

  • Physical Therapist
  • Farmington Hills, MI
  • NPI 1164579686
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1316993835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28051 DEQUINDRE RD STE D",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713016",
            "telephone_number": "248-733-5442",
            "fax_number": "248-963-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28051 DEQUINDRE RD STE D",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713016",
            "telephone_number": "248-733-5442",
            "fax_number": "248-963-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN TRIANGLE REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "ASMAR",
        "authorized_official_first_name": "DINA",
        "authorized_official_middle_name": "KAMAL",
        "authorized_official_title_or_position": "ADMINISTRATOR OWNER",
        "authorized_official_telephone_number": "619-402-7927"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30438",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Girvan
• Christian Gjolaj, PA-C
• Jeremy Marko Gjonaj
• Natasha Alexandra Gjonaj, BEHAVIOR TECHNICIAN
• Michelle Glazer-Zucker, D.O.
• Brooklyn Golden
• Shaynah Goldfine, D.P.M.
• Elisabeth Golus, RPH
• Good Day Home Care, Inc
• Goodwill Home Care Services, LLC

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.