Organization
GENESIS HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENDA LAVONNE GREEN PTA (PHYSICAL THERAPY ASSISTANT)
(410) 674-3755
Entity
Organization
Contact information
Practice address
35 MILKSHAKE LN, ANNAPOLIS, MD 21403-1507
(410) 269-5100
(410) 216-9123
Mailing address
1909 BULRUSH CT, ODENTON, MD 21113-2924
(410) 269-5100
(410) 216-9123
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
A2933
MD
Other
Enumeration date
04/12/2007
Last updated
09/06/2023
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