Healthcare Provider Details

I. General information

NPI: 1821235847
Provider Name (Legal Business Name): GENESIS REHABILITATIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 GREEN END AVE
MIDDLETOWN RI
02842-5620
US

IV. Provider business mailing address

145 YOUNGS AVE
COVENTRY RI
02816-7550
US

V. Phone/Fax

Practice location:
  • Phone: 401-849-7100
  • Fax:
Mailing address:
  • Phone: 401-821-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberOTA00416
License Number StateRI

VIII. Authorized Official

Name: MS. SANDRA PAULINE COLOZZO
Title or Position: CERTIFIED OCCUPATIONAL THERAPY ASST
Credential: COTA
Phone: 401-849-7100