Genesis Rehab Services

LBN: Sundance Services Corp
Genesis Rehab Services is an health care organization with primary practice located at 107 E Beckert Rd , New London WI 54961-2509. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Sundance Services Corp can be contacted via phone (920) 982-5354, or through Freisinger, Lori via phone (414) 531-5226.

Contact Information

Primary practice address
107 E Beckert Rd New London WI 54961-2509
Fax: (920) 982-9149
Website:
Authorized official contact:
Name: Freisinger, Lori Occupational Therapist (OT)

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 3026-154 Wisconsin

Profile Details

NPI number 1902144074
LBN Legal business name Sundance Services Corp
DBA Doing business as Genesis Rehab Services
Authorized official Freisinger, Lori Occupational Therapist (OT)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2013
Last updated Jan 24th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902144074 NPPES
Wisconsin Other 3026-154 STATE OF WISCONSIN - DSPS LICENSE RENEWAL
Wisconsin MEDICAID 42591500 STATE OF WISCONSIN - DSPS LICENSE RENEWAL

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