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General NPI Number Information
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NPI Number | 1679930440
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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 | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 19948 STATE ROUTE 93
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City | WELLSTON
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State | OH
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Zip | 45692-9048
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Country | US
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Telephone | 740-418-4015
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Fax |
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Provider Business Mailing Address
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Address Line | 19948 STATE ROUTE 93
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City | WELLSTON
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State | OH
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Zip | 45692-9048
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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 | OCCUPATIONAL THERAPY ASSISTANT
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Name | GEORGI EWING
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Credential | COTA/L
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Telephone | 740-418-4015
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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 |
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License Number State |
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