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General NPI Number Information
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NPI Number | 1730420332
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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 | 03/06/2013
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 41-749 MEKIA ST
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City | WAIMANALO
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State | HI
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Zip | 96795-1339
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Country | US
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Telephone | 973-330-2683
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Fax |
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Provider Business Mailing Address
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Address Line | 41-749 MEKIA STREET
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City | WAIMANALO
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State | HI
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Zip | 96795
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Country | US
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Telephone | 973-330-2683
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER REHAB
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Name | DAMIAN SEMPIO
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Credential |
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Telephone | 808-441-9538
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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 | 1195
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License Number State | HI
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