Genesis Rehab Services
Organization Active NPI Assisted Living Facility · Erie, PA
NPI 1215212105 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1215212105
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- OC010504 (PA)
- Legal business name
- GENESIS REHAB SERVICES
- Practice address
- 1012 W Bayfront Pkwy
Erie, PA 16507-2324 - Phone
- (814) 455-1630
- NPI assigned
- Oct 11, 2011
- Organization subpart
- No
Authorized official
- Name
- Kerri Myers
- Title
- Human Resources
- Phone
- (610) 925-2352
Corporate family (same tax ID) 19
National Provider Directory
- Tax ID family
- Genesis Rehab Serv
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | OC010504 | PA | Yes |
Addresses
Primary practice location
1012 W Bayfront Pkwy
Erie, PA 16507-2324
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-2352
NPI Registry JSON
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1318291200000",
"number": "1215212105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E STATE ST",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193483109",
"telephone_number": "610-925-2352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 W BAYFRONT PKWY",
"city": "ERIE",
"state": "PA",
"postal_code": "165072324",
"telephone_number": "814-455-1630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESIS REHAB SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A",
"authorized_official_last_name": "MYERS",
"authorized_official_first_name": "KERRI",
"authorized_official_title_or_position": "HUMAN RESOURCES",
"authorized_official_telephone_number": "610-925-2352"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "PA",
"license": "OC010504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.