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Organization

GENESIS HEALTHCARE

Active
Other names
Funtional Life Achievement Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ALICIA WANG MS-CCC/SLP (SPEEH LANGUAGE PATHOLOGIST)
(617) 663-7023
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
07/01/2011
Last updated
12/06/2011
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