Provider Demographics
NPI:1922717875
Name:GENESIS REHABILITATION LLC
Entity Type:Organization
Organization Name:GENESIS REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REGAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:908-208-4104
Mailing Address - Street 1:1025 SCHMIDT LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1355
Mailing Address - Country:US
Mailing Address - Phone:908-208-4104
Mailing Address - Fax:
Practice Address - Street 1:1025 SCHMIDT LN
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1355
Practice Address - Country:US
Practice Address - Phone:908-208-4104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health