Organization
GENESIS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE RENEE GANTNER COTA/L (PROGRAM MANAGER)
(636) 379-9106
Entity
Organization
Contact information
Practice address
250 S NEW FLORISSANT RD, FLORISSANT, MO 63031-6716
(314) 830-7950
Mailing address
647 LOGAN VALLEY DR, SAINT PETERS, MO 63376-3799
(636) 379-9106
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1999137004
MO
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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