Provider Demographics
NPI:1316329352
Name:GENESIS ELDERCARE REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:GENESIS ELDERCARE REHABILITATION SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HIRSCHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4025
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:C/O AMY NUNEMAKER
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4560
Mailing Address - Fax:
Practice Address - Street 1:6850 RIVER RD
Practice Address - Street 2:C/O RIVERPLACE
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-2388
Practice Address - Country:US
Practice Address - Phone:762-821-2734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation