| Diverge Community Services, Llc | |
|
386 Eastlook Dr Saline MI 48176-1511 | |
| (734) 999-0290 | |
| Not Available |
| Full Name | Diverge Community Services, Llc |
|---|---|
| Speciality | Occupational Therapist |
| Location | 386 Eastlook Dr, Saline, Michigan |
| Authorized Official Name and Position | Rachel Robertson (CO-FOUNDER AND THERAPIST) |
| Authorized Official Contact | 7349990290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diverge Community Services, Llc 386 Eastlook Dr Saline MI 48176-1511 Ph: (734) 999-0290 | Diverge Community Services, Llc 386 Eastlook Dr Saline MI 48176-1511 Ph: (734) 999-0290 |
| NPI Number | 1174230270 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 01/14/2025 |
| Certification Date | 01/14/2025 |
| Medicare PECOS PAC ID | 1254872682 |
|---|---|
| Medicare Enrollment ID | O20240925001026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174230270 | NPI | - | NPPES |
| Provider Name | Rachel W Robertson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053929760 PECOS PAC ID: 3476979568 Enrollment ID: I20200819004092 |
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