Provider Demographics
NPI:1710229901
Name:GENESIS REHABILITATION
Entity Type:Organization
Organization Name:GENESIS REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-681-1001
Mailing Address - Street 1:161 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-2662
Mailing Address - Country:US
Mailing Address - Phone:508-477-2490
Mailing Address - Fax:508-477-9656
Practice Address - Street 1:161 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2662
Practice Address - Country:US
Practice Address - Phone:508-477-2490
Practice Address - Fax:508-477-9656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1461314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility