Healthcare Provider Details

I. General information

NPI: 1376114413
Provider Name (Legal Business Name): GENESIS REHABILITATION HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 BROOKS BARTRAM DRIVE
JACKSONVILLE FL
32258
US

IV. Provider business mailing address

3599 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-4252
US

V. Phone/Fax

Practice location:
  • Phone: 904-809-8080
  • Fax: 904-809-8081
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: JENI ALLEN
Title or Position: DIRECTOR OF MANAGED CARE
Credential:
Phone: 904-345-7158