| Sacred Heart Rehabilitation Center, Inc | |
|
2091 Professional Dr Ste I-1 Flint MI 48532-3657 | |
| (810) 732-1652 | |
| (810) 732-1735 |
| Full Name | Sacred Heart Rehabilitation Center, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2091 Professional Dr Ste I-1, Flint, Michigan |
| Authorized Official Name and Position | Grady Wilkinson (PRESIDENT CEO) |
| Authorized Official Contact | 8103922167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Heart Rehabilitation Center, Inc Po Box 41038 Memphis MI 48041-1038 Ph: (810) 392-2167 | Sacred Heart Rehabilitation Center, Inc 2091 Professional Dr Ste I-1 Flint MI 48532-3657 Ph: (810) 732-1652 |
| NPI Number | 1104959493 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5395771240 |
|---|---|
| Medicare Enrollment ID | O20050712000553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104959493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 250328 (Michigan) | Primary |
| Provider Name | Timothy D Hoffmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295797942 PECOS PAC ID: 8729057906 Enrollment ID: I20040927000130 |
| Provider Name | Maimoona Hakim Husain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487731816 PECOS PAC ID: 5496794166 Enrollment ID: I20050502000992 |
| Provider Name | Daniel J Grogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851499776 PECOS PAC ID: 7517969405 Enrollment ID: I20070206000272 |
| Provider Name | Janis E Romanik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023234200 PECOS PAC ID: 3173687001 Enrollment ID: I20090121000553 |
| Provider Name | Michael W Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932218104 PECOS PAC ID: 0042355950 Enrollment ID: I20100303000675 |
| Provider Name | Keri L Grubb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346488566 PECOS PAC ID: 1850577313 Enrollment ID: I20110517000763 |
| Provider Name | Amy L Perugi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033260187 PECOS PAC ID: 6800069972 Enrollment ID: I20111105000085 |
| Provider Name | Heidi E Grogan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720237407 PECOS PAC ID: 4284889064 Enrollment ID: I20130227000610 |
| Provider Name | Jeffery Steenbergh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811043466 PECOS PAC ID: 7416178454 Enrollment ID: I20141016001580 |
| Provider Name | Kori L Agius |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962783662 PECOS PAC ID: 1355563628 Enrollment ID: I20141121000723 |
| Provider Name | Yasmin Keshavjee |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1477920510 PECOS PAC ID: 1153630058 Enrollment ID: I20151015001291 |
| Provider Name | Joanne Dinunzio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447274097 PECOS PAC ID: 0143526996 Enrollment ID: I20160304000892 |
| Provider Name | Pamela A Kaatz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053752550 PECOS PAC ID: 5294020079 Enrollment ID: I20160817002879 |
| Provider Name | Shatina Marks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124368634 PECOS PAC ID: 3476837238 Enrollment ID: I20170223001042 |
| Provider Name | Stephanie Rudow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841625076 PECOS PAC ID: 7618237231 Enrollment ID: I20180130002104 |
| Provider Name | Tricia Newland Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154739597 PECOS PAC ID: 9739428285 Enrollment ID: I20190228001868 |
| Provider Name | Michael A Jushak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679997464 PECOS PAC ID: 7517206543 Enrollment ID: I20190308000596 |
| Provider Name | Ryanne L Grygorcewicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679693329 PECOS PAC ID: 6709203268 Enrollment ID: I20200828000733 |
| Provider Name | Jessica Billups |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356810030 PECOS PAC ID: 0941604078 Enrollment ID: I20210811001118 |
| Provider Name | Christine A Alcantara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023612090 PECOS PAC ID: 1052767209 Enrollment ID: I20231025001208 |
| Provider Name | April Gaines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689821084 PECOS PAC ID: 1850743857 Enrollment ID: I20240116000459 |
| Provider Name | David William Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801878202 PECOS PAC ID: 8022454255 Enrollment ID: I20240311002703 |
| Provider Name | Ashley Polinski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225508450 PECOS PAC ID: 9537507876 Enrollment ID: I20240404002924 |
| Provider Name | Zoe Lazar-hale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437604436 PECOS PAC ID: 3779922281 Enrollment ID: I20240417000878 |
| Provider Name | Tamera Huntley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104208057 PECOS PAC ID: 8426497546 Enrollment ID: I20240422001678 |
| Provider Name | Craig Ford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952555856 PECOS PAC ID: 0840387494 Enrollment ID: I20240424000173 |
| Provider Name | Cathryn E. Bickes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316074297 PECOS PAC ID: 3678919818 Enrollment ID: I20240424000465 |
| Provider Name | Rene Amyotte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356658371 PECOS PAC ID: 8325488141 Enrollment ID: I20240426002490 |
| Provider Name | Shawna Milligan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386807535 PECOS PAC ID: 7810337995 Enrollment ID: I20240507000856 |
| Provider Name | Janessa Reder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538518790 PECOS PAC ID: 7214378264 Enrollment ID: I20240508003360 |
| Provider Name | Michelle Zoch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558670075 PECOS PAC ID: 9830530450 Enrollment ID: I20240514003278 |
| Provider Name | Sherie Heinbuck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568518934 PECOS PAC ID: 4082156401 Enrollment ID: I20240612003236 |
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