Provider Demographics
NPI:1114570629
Name:GENERATIONS REHAB SERVICES, INC
Entity Type:Organization
Organization Name:GENERATIONS REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE-DESTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:954-305-5001
Mailing Address - Street 1:2380 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3025
Mailing Address - Country:US
Mailing Address - Phone:954-305-5001
Mailing Address - Fax:954-391-9736
Practice Address - Street 1:10031 PINES BLVD STE 216
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6169
Practice Address - Country:US
Practice Address - Phone:954-305-5001
Practice Address - Fax:954-391-9736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115425900Medicaid