# GENESIS REHAB

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

## Provider details

- **NPI number:** 1679817696
- **Authorized official:** MARIE ANTOINETTE CARBO M.S. OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (484) 557-6601

## Contact information

- **Practice address:** 146 MARPLE RD, BROOMALL, PA 19008-2040
- **Practice address phone:** (610) 356-0100
- **Mailing address:** 905 CHARLESTON GRN, MALVERN, PA 19355-2457
- **Mailing address phone:** (484) 557-6601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | OC012201 | PA | Yes |

## Other

- **Enumeration date:** 11/15/2012
- **Last updated:** 11/15/2012