# GENESIS HEALTHCARE

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

## Provider details

- **NPI number:** 1134358872
- **Authorized official:** LACEY WATFORD MSOTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (757) 685-1046

## Contact information

- **Practice address:** 4560 PRINCESS ANNE RD, VIRGINIA BEACH, VA 23462-7905
- **Practice address phone:** (757) 495-4211
- **Mailing address:** 509 SPRING LAKE CRES APT 302, VIRGINIA BEACH, VA 23451-6406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/02/2009
- **Last updated:** 07/02/2009