Provider Demographics
NPI:1194162461
Name:GENESIS REHAB SERVICES
Entity type:Organization
Organization Name:GENESIS REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:603-934-2541
Mailing Address - Street 1:7 BALDWIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2000
Mailing Address - Country:US
Mailing Address - Phone:603-934-2541
Mailing Address - Fax:
Practice Address - Street 1:7 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2000
Practice Address - Country:US
Practice Address - Phone:603-934-2541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0655314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility