# GENESIS HEALTHCARE SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104150580
- **Authorized official:** MS. CONNIE FINCH (OFFICE MANAGER)
- **Authorized official phone:** (909) 902-5588

## Contact information

- **Practice address:** 11760 CENTRAL AVE STE 125, CHINO, CA 91710-1909
- **Practice address phone:** (909) 502-5588
- **Practice address fax:** (909) 902-1013
- **Mailing address:** 11760 CENTRAL AVE STE 125, CHINO, CA 91710-1909
- **Mailing address phone:** (909) 502-5588
- **Mailing address fax:** (909) 902-1013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 34087 | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2009
- **Last updated:** 10/30/2009