Healthcare Provider Details

I. General information

NPI: 1104101443
Provider Name (Legal Business Name): GENESIS REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 TWIN SILO DR
BLUE BELL PA
19422-4202
US

IV. Provider business mailing address

9000 TWIN SILO DR
BLUE BELL PA
19422-4202
US

V. Phone/Fax

Practice location:
  • Phone: 215-611-8727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberTOP008356
License Number StatePA

VIII. Authorized Official

Name: SIMONETTE LIBRE-SABIO
Title or Position: PROGRAM MANAGER
Credential: PT
Phone: 215-699-8727