Provider Demographics
NPI:1467774182
Name:GENESIS REHAB SERVICES
Entity Type:Organization
Organization Name:GENESIS REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CIAVARRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-537-6149
Mailing Address - Street 1:9 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3152
Mailing Address - Country:US
Mailing Address - Phone:724-961-2180
Mailing Address - Fax:
Practice Address - Street 1:500 BROUWERS DR
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2500
Practice Address - Country:US
Practice Address - Phone:724-537-6149
Practice Address - Fax:724-537-6156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009309310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility