Healthcare Provider Details

I. General information

NPI: 1538355821
Provider Name (Legal Business Name): GENESIS REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 N MAIN ST
SOUTH YARMOUTH MA
02664-2083
US

IV. Provider business mailing address

265 N MAIN ST
SOUTH YARMOUTH MA
02664-2083
US

V. Phone/Fax

Practice location:
  • Phone: 508-394-3514
  • Fax:
Mailing address:
  • Phone: 508-394-3514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1097
License Number StateMA

VIII. Authorized Official

Name: KRISTEN M WORKS
Title or Position: COTA/L
Credential:
Phone: 508-394-3514