Healthcare Provider Details

I. General information

NPI: 1235368010
Provider Name (Legal Business Name): GENESIS REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 S MAIN ST
QUAKERTOWN PA
18951
US

IV. Provider business mailing address

465 KLEMAN RD
GILBERTSVILLE PA
19525-9720
US

V. Phone/Fax

Practice location:
  • Phone: 215-536-9300
  • Fax:
Mailing address:
  • Phone: 484-524-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberTEI000189
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: JENNIFER LYNN WILSON
Title or Position: PTA
Credential:
Phone: 484-524-8048