# 1526 LOMBARD STREET OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENESIS PA HOLDINGS LLC
- **Other names:** PowerBack Rehabilitation 1526 Lombard Street
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427230739
- **Legal business name:** GENESIS PA HOLDINGS LLC
- **Authorized official:** MICHAEL T BERG (ASSISTANT SECRETARY)
- **Authorized official phone:** (505) 468-4742

## Contact information

- **Practice address:** 1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
- **Practice address phone:** (215) 546-6960
- **Practice address fax:** (215) 732-7451
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (610) 925-2009
- **Mailing address fax:** (610) 347-4098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 200402 | PA | Yes |

## Other

- **Enumeration date:** 11/28/2007
- **Last updated:** 05/03/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1025711460001 | — | PA |