Healthcare Provider Details

I. General information

NPI: 1134534449
Provider Name (Legal Business Name): GENESIS REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 WEST ARKANSAS AVENUE
DENVER CO
80219
US

IV. Provider business mailing address

1335 COLUMBINE STREET APT 302
DENVER CO
80206
US

V. Phone/Fax

Practice location:
  • Phone: 303-936-1866
  • Fax:
Mailing address:
  • Phone: 518-598-7525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER DAVIS
Title or Position: PTA/PM
Credential:
Phone: 303-936-0831