Provider Demographics
NPI:1174688287
Name:GENERATION HEALTH & REHABILITATION
Entity Type:Organization
Organization Name:GENERATION HEALTH & REHABILITATION
Other - Org Name:FLINT RIDGE NURSING AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-348-1389
Mailing Address - Street 1:1450 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3653
Mailing Address - Country:US
Mailing Address - Phone:740-348-1300
Mailing Address - Fax:740-344-3091
Practice Address - Street 1:1450 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3653
Practice Address - Country:US
Practice Address - Phone:740-348-1300
Practice Address - Fax:740-344-3091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1489N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2390523Medicaid
OH2390523Medicaid