Provider Demographics
NPI:1093131716
Name:GENESIS ELDERCARE REHABILITATION SERVICES INC
Entity Type:Organization
Organization Name:GENESIS ELDERCARE REHABILITATION SERVICES INC
Other - Org Name:GENESIS REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4409
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4432
Mailing Address - Fax:
Practice Address - Street 1:1967 HIGHWAY 54 W
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4747
Practice Address - Country:US
Practice Address - Phone:770-631-2338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation