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General NPI Number Information
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NPI Number | 1467774182
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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 | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 500 BROUWERS DR
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City | LATROBE
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State | PA
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Zip | 15650-2500
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Country | US
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Telephone | 724-537-6149
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Fax | 724-537-6156
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Provider Business Mailing Address
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Address Line | 9 WAYNE AVE
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City | JEANNETTE
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State | PA
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Zip | 15644-3152
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Country | US
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Telephone | 724-961-2180
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Fax |
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Authorized Official
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Title or Position | PT/PROGRAM MANAGER
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Name | MARILYN N CIAVARRA
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Credential | PT
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Telephone | 724-537-6149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | SL009309
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License Number State | PA
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