Organization
GENESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA KELI CHARLES COTA (OCCUPATIONAL THERAPY ASSISTANT)
(248) 794-4467
Entity
Organization
Contact information
Practice address
505 CANON AVE, APT 2, MANITOU SPRINGS, CO 80829-2947
(248) 794-4467
Mailing address
505 CANON AVE, APT 2, MANITOU SPRINGS, CO 80829-2947
(248) 794-4467
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0000038
CO
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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