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General NPI Number Information
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NPI Number | 1467575217
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Entity Type | Organization
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Legal Business Name | GENESIS REHAB SERVICES
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4240 LAKELAND HIGHLANDS RD
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City | LAKELAND
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State | FL
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Zip | 33813-3113
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Country | US
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Telephone | 862-607-5948
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Fax |
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Provider Business Mailing Address
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Address Line | 255 KINGS POND AVE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-1926
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Country | US
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Telephone | 863-295-7899
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Fax |
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Authorized Official
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Title or Position | REHAB MANAGER
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Name | MRS. KIMBERLY OCHS
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Credential | MSCCCSLP
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Telephone | 863-607-5948
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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 | OTA10363
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License Number State | FL
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