MEDICARE: GENESIS REHAB SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	NV 12-0256	NV

General Provider Information

NPI Number	:	1639569452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS REHAB SERVICES

Provider Business Mailing Address
First Line	:	4921 CALABASH TREE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1686
Country	:	US
Telephone Number	:	619-888-5282
Fax Number	:

Provider Business Practice Location Address
First Line	:	4921 CALABASH TREE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1686
Country	:	US
Telephone Number	:	619-888-5282
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MR. ERWIN CORVERA ARPON
Credential	:	OTR
Telephone Number	:	619-888-5282

Provider Enumeration Date	:	02/01/2015
Last Update Date	:	02/01/2015

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