Organization
GENESIS HEALTHCARE LEBANON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY REA-FARMER (PT)
(802) 295-7391
Entity
Organization
Contact information
Practice address
1218 SOUTH RANDOLPH ROAD, RANDOLPH CENTER, VT 05061
(802) 728-9786
Mailing address
1218 S RANDOLPH RD, RANDOLPH CENTER, VT 05061-9528
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/03/2010
Last updated
08/18/2010
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