Healthcare Provider Details

I. General information

NPI: 1225085434
Provider Name (Legal Business Name): CAPITAL REGION GENESIS ELDERCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 LANGLEY PKWY
CONCORD NH
03301-7533
US

IV. Provider business mailing address

101 E STATE ST
KENNETT SQUARE PA
19348-3109
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-0777
  • Fax: 603-226-7474
Mailing address:
  • Phone: 610-925-4436
  • Fax: 610-925-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number02698
License Number StateNH

VIII. Authorized Official

Name: JANE DROPESKEY
Title or Position: CORPORATE MANAGE
Credential:
Phone: 610-925-4231