Basic Information
| Provider Information | |||||||||
| NPI: | 1770838427 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GENESIS REHAB SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 AUTUMN RUN | ||||||||
| Address2: | |||||||||
| City: | HOOKSETT | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031061953 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 239 PLEASANT ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033017504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032246561 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2012 | ||||||||
| LastUpdateDate: | 07/18/2012 | ||||||||
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| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | JEANMARIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | HR ASSOCIATE | ||||||||
| AuthorizedOfficialTelephone: | 8005846520 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.