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General NPI Number Information
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NPI Number | 1417278672
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Entity Type | Organization
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Legal Business Name | GENESIS HEALTHCARE
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 2511 BENTLEY DR
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City | SALEM
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State | OH
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Zip | 44460-2503
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Country | US
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Telephone | 330-337-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 590 N HOWARD AVE
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City | SALEM
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State | OH
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Zip | 44460-2128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COTA/L
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Name | MS. AMANDA M SCHWARTZ
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Credential |
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Telephone | 330-332-9204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 03556
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License Number State | OH
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