Provider Demographics
NPI:1831313071
Name:GENESIS REHAB SERVICES
Entity Type:Organization
Organization Name:GENESIS REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:DURAND
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:301-934-4001
Mailing Address - Street 1:42249 BIRD HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-3628
Mailing Address - Country:US
Mailing Address - Phone:301-475-1662
Mailing Address - Fax:
Practice Address - Street 1:1 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-9357
Practice Address - Country:US
Practice Address - Phone:301-934-4001
Practice Address - Fax:301-392-3726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04929313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility