Provider Demographics
NPI:1841524238
Name:GENESIS REHABILITATION SERVICES
Entity type:Organization
Organization Name:GENESIS REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GOWER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:610-865-5595
Mailing Address - Street 1:1200 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-4940
Mailing Address - Country:US
Mailing Address - Phone:610-865-5595
Mailing Address - Fax:610-997-8413
Practice Address - Street 1:1200 SPRING ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-4940
Practice Address - Country:US
Practice Address - Phone:610-865-5595
Practice Address - Fax:610-997-8413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006777302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization