Provider Demographics
NPI:1639569452
Name:GENESIS REHAB SERVICES
Entity Type:Organization
Organization Name:GENESIS REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:CORVERA
Authorized Official - Last Name:ARPON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:619-888-5282
Mailing Address - Street 1:4921 CALABASH TREE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1686
Mailing Address - Country:US
Mailing Address - Phone:619-888-5282
Mailing Address - Fax:
Practice Address - Street 1:4921 CALABASH TREE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1686
Practice Address - Country:US
Practice Address - Phone:619-888-5282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS REHAB SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-01
Last Update Date:2015-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV 12-0256314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility