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General NPI Number Information
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NPI Number | 1871844928
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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 | 09/28/2012
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 2940 W 87TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-3832
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Country | US
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Telephone | 773-306-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 2940 W 87TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-3832
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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 | SPEECH-LANGUAGE PATHOLOGIST
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Name | SARAH LEBLANC
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Credential |
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Telephone | 508-277-8623
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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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