Provider Demographics
NPI:1548331218
Name:ACTIVE REHAB CENTER, INC.
Entity type:Organization
Organization Name:ACTIVE REHAB CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLOMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-399-1060
Mailing Address - Street 1:54714 LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042
Mailing Address - Country:US
Mailing Address - Phone:586-786-7574
Mailing Address - Fax:586-786-1308
Practice Address - Street 1:28200 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071
Practice Address - Country:US
Practice Address - Phone:248-399-1060
Practice Address - Fax:248-399-3848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM14516Medicare PIN