Healthcare Provider Details

I. General information

NPI: 1447611728
Provider Name (Legal Business Name): GENESIS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2016
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3864 SWEETEN CREEK RD
ARDEN NC
28704-3136
US

IV. Provider business mailing address

3864 SWEETEN CREEK RD
ARDEN NC
28704-3136
US

V. Phone/Fax

Practice location:
  • Phone: 828-458-6756
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number14910
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANAIS STRICKLING
Title or Position: DPT
Credential: DPT
Phone: 828-582-3358