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General NPI Number Information
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NPI Number | 1356637201
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Entity Type | Organization
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Legal Business Name | GENESIS REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 21810 BURBANK HL
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City | SAN ANTONIO
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State | TX
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Zip | 78256-1677
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Country | US
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Telephone | 210-698-1836
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Fax | 210-698-1836
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Provider Business Mailing Address
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Address Line | 21810 BURBANK HL
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City | SAN ANTONIO
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State | TX
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Zip | 78256-1677
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Country | US
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Telephone | 210-698-1836
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Fax | 210-698-1836
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Authorized Official
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Title or Position | CEO/CNO
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Name | CHARLOTTE DAVIS
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Credential | RN, BSN, CART
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Telephone | 210-698-1836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2644951
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 2644951
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2644951
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 2644951
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2644951
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 2644951
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License Number State | TX
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