Active NPI
Pure Relief Rehab Center
- Internal Medicine Physician
- Warren, MI
National Provider Identifier
1336856921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- PURE RELIEF REHAB CENTER
- Practice address
- 2104 E 11 Mile Rd Ste 100
Warren, MI 48091-6121 - Phone
- (586) 486-5727
- Fax
- (586) 486-5736
- NPI assigned
- Nov 2, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Tara King
- Title
- Business Owner
- Phone
- (313) 765-7128
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
2104 E 11 Mile Rd Ste 100
Warren, MI 48091-6121
Mailing address
2104 E 11 Mile Rd Ste 100
Warren, MI 48091-6121
Phone (586) 486-5727
National Provider Directory
National Provider DirectoryLocations
2104 E 11 Mile Rd
Ste 100
Warren, MI 48091
Phone (586) 619-7840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667347200000",
"number": "1336856921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 E 11 MILE RD STE 100",
"city": "WARREN",
"state": "MI",
"postal_code": "480916121",
"telephone_number": "586-486-5727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 E 11 MILE RD STE 100",
"city": "WARREN",
"state": "MI",
"postal_code": "480916121",
"telephone_number": "586-486-5727",
"fax_number": "586-486-5736"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PURE RELIEF REHAB CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-02",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A",
"authorized_official_last_name": "KING",
"authorized_official_first_name": "TARA",
"authorized_official_title_or_position": "BUSINESS OWNER",
"authorized_official_telephone_number": "313-765-7128",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.