Provider Demographics
NPI:1134534449
Name:GENESIS REHABILITATION
Entity type:Organization
Organization Name:GENESIS REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PTA/PM
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-936-0831
Mailing Address - Street 1:1335 COLUMBINE STREET
Mailing Address - Street 2:APT 302
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206
Mailing Address - Country:US
Mailing Address - Phone:518-598-7525
Mailing Address - Fax:
Practice Address - Street 1:3105 WEST ARKANSAS AVENUE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219
Practice Address - Country:US
Practice Address - Phone:303-936-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility