| Organization Name: | GENESIS ELDERCARE REHABILITATION SERVICES LLC |
| NPI Number: | 1053725432 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL A HIRSCHFELD (PRESIDENT) |
| Mailing Address: | 1505 Patton Dr C/o Bridle Brook Adult Community Mahomet |
| State: | IL US |
| Postal Code: | 618538116 |
| Phone Number: | 2175863749 |
| Fax Number: | |
| NPI Enumeration Date: | 06/13/2014 |
| NPI Last Update Date: | 04/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |