Provider Demographics
NPI:1285968560
Name:GENESIS REHAB SERVICES
Entity type:Organization
Organization Name:GENESIS REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MUTSUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONOKAMI-CURIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-774-4700
Mailing Address - Street 1:2662 WYMAN RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3820
Mailing Address - Country:US
Mailing Address - Phone:336-774-4700
Mailing Address - Fax:
Practice Address - Street 1:2101 HOMESTEAD HILLS DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6445
Practice Address - Country:US
Practice Address - Phone:336-774-8942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility