Provider Demographics
NPI:1649989633
Name:GENESIS HEALTHCARE SERVICES
Entity type:Organization
Organization Name:GENESIS HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-627-2600
Mailing Address - Street 1:1414 S GREEN RD STE 107
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3936
Mailing Address - Country:US
Mailing Address - Phone:440-627-2600
Mailing Address - Fax:440-624-2600
Practice Address - Street 1:1414 S GREEN RD STE 107
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3936
Practice Address - Country:US
Practice Address - Phone:440-627-2600
Practice Address - Fax:440-624-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health