# GENESIS HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Funtional Life Achievement Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295022978
- **Authorized official:** MS. ALICIA WANG MS-CCC/SLP (SPEEH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (617) 663-7023

## Contact information

- **Practice address:** 161 MADISON AVE, 2ND FLOOR, NEW YORK, NY 10016-5421
- **Practice address phone:** (212) 683-8905
- **Mailing address:** 206 E 17TH ST APT 5C, NEW YORK, NY 10003-3636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 021023 | NY | Yes |
| 314000000X | Skilled Nursing Facility | 7941 | MA | — |

## Other

- **Enumeration date:** 07/01/2011
- **Last updated:** 12/06/2011