My Tactical Advantage LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

MY TACTICAL ADVANTAGE LLC

Practice address

13305 W 7 Mile Rd
Detroit, MI 48235-1340

Phone

(313) 544-8229

NPI assigned

Jan 23, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Tareeq Elmore

Title

Ceo/ Owner

Phone

(313) 544-8229

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1942747423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351340",
            "telephone_number": "313-544-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351340",
            "telephone_number": "313-544-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY TACTICAL ADVANTAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "TAREEQ",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "313-544-8229",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Detroit, MI
• Providers in Detroit, 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 Jan 23, 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.