Provider Demographics
NPI:1922585991
Name:GENESIS ELDERCARE REHAB SVCS
Entity Type:Organization
Organization Name:GENESIS ELDERCARE REHAB SVCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST-CLINICAL FELLOW
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-933-0808
Mailing Address - Street 1:9404 OWINGS HEIGHTS CIR APT 304
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6396
Mailing Address - Country:US
Mailing Address - Phone:443-933-0808
Mailing Address - Fax:
Practice Address - Street 1:3300 WILKENS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4610
Practice Address - Country:US
Practice Address - Phone:410-525-1544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty