Organization
GENESIS HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY WATFORD MSOTR/L (OCCUPATIONAL THERAPIST)
(757) 685-1046
Entity
Organization
Contact information
Practice address
4560 PRINCESS ANNE RD, VIRGINIA BEACH, VA 23462-7905
(757) 495-4211
Mailing address
509 SPRING LAKE CRES APT 302, VIRGINIA BEACH, VA 23451-6406
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/02/2009
Last updated
07/02/2009
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