Basic Information
| Provider Information | |||||||||
| NPI: | 1902229321 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GENESIS REHAB SERVECES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7950 LAKE UNDERHILL RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328228229 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 7950 LAKE UNDERHILL RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328228229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076016888 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2014 | ||||||||
| LastUpdateDate: | 01/22/2014 | ||||||||
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| AuthorizedOfficialLastName: | ROULHAC | ||||||||
| AuthorizedOfficialFirstName: | JAHVUN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPY ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 3212028449 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.