Provider Demographics
NPI:1104101443
Name:GENESIS REHAB SERVICES
Entity type:Organization
Organization Name:GENESIS REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIMONETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBRE-SABIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-699-8727
Mailing Address - Street 1:9000 TWIN SILO DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-4202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9000 TWIN SILO DR
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-4202
Practice Address - Country:US
Practice Address - Phone:215-611-8727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATOP008356314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility