Provider Demographics
NPI:1306075700
Name:GENESIS HEALTH CARE
Entity type:Organization
Organization Name:GENESIS HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:610-998-2419
Mailing Address - Street 1:7 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-1354
Mailing Address - Country:US
Mailing Address - Phone:610-998-2419
Mailing Address - Fax:
Practice Address - Street 1:7 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:PA
Practice Address - Zip Code:19363-1354
Practice Address - Country:US
Practice Address - Phone:610-998-2419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASLP 235Z00000X314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility