Organization Active NPI

Lakeland Neuro Care Center PTR

  • Rehabilitation Clinic/Center
  • Southfield, MI
National Provider Identifier
1760602668
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LAKELAND NEURO CARE CENTER PTR
Practice address
26900 Franklin Rd.
Southfield, MI 48033
Phone
(248) 350-8070
Fax
(248) 350-9734
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Mr. Gary Ernest Romanelli
Title
Coo & Cfo
Phone
(248) 350-8070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

26900 Franklin Rd.
Southfield, MI 48033

Mailing address

26900 Franklin Rd.
Southfield, MI 48033
Phone (248) 350-8070

Other identifiers 1

IdentifierTypeStateIssuer
604846736MedicaidMI

Other names 1

  • The Lakeland Center Other name

National Provider Directory

National Provider Directory

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1760602668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26900 FRANKLIN RD.",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "248-350-8070",
            "fax_number": "248-350-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26900 FRANKLIN RD.",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "248-350-8070",
            "fax_number": "248-350-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND NEURO CARE CENTER PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "ROMANELLI",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "COO & CFO",
        "authorized_official_telephone_number": "248-350-8070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "604846736",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lakeland Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.