OrganizationActive
Genesis Rehab Services LLC
NPI 1790062594 · Physical Therapy Clinic/Center · Saint John, IN
Provider details
- NPI number
- 1790062594
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charru Malik, Sole Mbr(219) 616-5727
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9430 Wicker Ave
1534 119th Street
Saint John, IN 46373-9768
Phone: (219) 655-5285
Fax: (219) 655-5472
Street-level locationGet directions
Mailing address
9430 Wicker Ave
Saint John, IN 46373-9768
Other names (DBA / former)
- Doing business as
- Genesis Rehab
Registry dates
- Enumerated
- 2011-11-08
- Last updated
- 2017-05-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.