# GENESIS REHAB SERVICES

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

## Provider details

- **NPI number:** 1497180061
- **Authorized official:** MRS. NIKETA DHAVAL PATEL C.O.T.A. (PROGRAM MANAGER / COTA)
- **Authorized official phone:** (734) 306-3054

## Contact information

- **Practice address:** 34330 VAN BORN RD, WAYNE, MI 48184-2472
- **Practice address phone:** (734) 721-9108
- **Practice address fax:** (734) 729-5782
- **Mailing address:** 34330 VAN BORN RD, WAYNE, MI 48184-2472
- **Mailing address phone:** (734) 721-9108
- **Mailing address fax:** (734) 729-5782

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 5202006033 | MI | Yes |

## Other

- **Enumeration date:** 09/13/2013
- **Last updated:** 09/13/2013