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General NPI Number Information
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NPI Number | 1699143297
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Entity Type | Organization
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Legal Business Name | GENESIS ELDER CARE REHABILITATION SERVICES, INC
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Dates
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Enumeration Date | 09/13/2015
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Last Update Date | 09/13/2015
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Provider Practice Location Address
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Address Line | 813 KELLER LN
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City | TUSCUMBIA
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State | AL
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Zip | 35674-1110
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Country | US
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Telephone | 256-383-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 813 KELLER LN
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City | TUSCUMBIA
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State | AL
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Zip | 35674-1110
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Country | US
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Telephone | 256-383-1535
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THREALIST/REHAB DIRECTOR
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Name | MR. CHAD FISHER
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Credential | PTA, RD
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Telephone | 813-727-7741
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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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