Provider Demographics
NPI:1548495898
Name:GENESIS HEALTH AND EDUCATION
Entity type:Organization
Organization Name:GENESIS HEALTH AND EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KALUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-349-0034
Mailing Address - Street 1:12120 CHANCERY STATION CIR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5800
Mailing Address - Country:US
Mailing Address - Phone:703-349-0034
Mailing Address - Fax:703-349-0365
Practice Address - Street 1:2 WISCONSIN CIR
Practice Address - Street 2:SUITE 700
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7003
Practice Address - Country:US
Practice Address - Phone:703-349-0034
Practice Address - Fax:703-349-0365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003170235Z00000X
MD03798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty