Healthcare Provider Details

I. General information

NPI: 1467787473
Provider Name (Legal Business Name): GENESIS REHABILITATION CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR # 2 KM. 19.2 BARRIO CANDELARIA
TOA BAJA PR
00949
US

IV. Provider business mailing address

CARR # 2 KM 19.2 BARRIO CANDELARIA
TOA BAJA PR
00949
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-7100
  • Fax: 787-251-7999
Mailing address:
  • Phone: 787-740-7100
  • Fax: 787-251-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberN/A
License Number StatePR

VIII. Authorized Official

Name: MS. MARIBEL ALVARADO
Title or Position: PRESIDENT/CEO
Credential:
Phone: 787-740-7100