Provider Demographics
NPI:1700020880
Name:GENESIS HEALTH AND REHAB
Entity Type:Organization
Organization Name:GENESIS HEALTH AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COTA
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-776-1029
Mailing Address - Street 1:3585 BRAMBLETON AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6521
Mailing Address - Country:US
Mailing Address - Phone:540-776-1029
Mailing Address - Fax:
Practice Address - Street 1:3585 BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6521
Practice Address - Country:US
Practice Address - Phone:540-776-1029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000110224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty