Basic Information
| Provider Information | |||||||||
| NPI: | 1255623476 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GENESIS REHAB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 820 E CENTER ST | ||||||||
| Address2: | |||||||||
| City: | BLANCHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451071310 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 820 E CENTER ST | ||||||||
| Address2: | |||||||||
| City: | BLANCHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451071310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377834949 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2011 | ||||||||
| LastUpdateDate: | 05/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | ADKINS | ||||||||
| AuthorizedOfficialFirstName: | ASHTON | ||||||||
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| AuthorizedOfficialTitleorPosition: | OCCUPATIONAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 9372183376 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MOTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 007671 | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.