175 BLUEBERRY LANE OPERATIONS LLC

LACONIA REHABILITATION CENTER, GENESIS HEALTHCARE

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Basic Info
Government P.O.C.
Alt. Government P.O.C.
Past Performance P.O.C.
Alt. Past Performance P.O.C.
Electronic P.O.C.
Alt. Electronic P.O.C.
NAICS Information
Disaster Response Codes
PSC Codes
Basic Info
Legal Business Name 175 BLUEBERRY LANE OPERATIONS LLC
DBA Name LACONIA REHABILITATION CENTER, GENESIS HEALTHCARE
Registration Status Active
Expiration Date January, 11 2022
DUNS 001014406
DUNS +4 0000
CAGE 81TD
Primary NAICS 623110 - Nursing Care Facilities (Skilled Nursing Facilities)
Corporate Structure 2L

Physical Address
Business Started September, 24 2007
Congressional District 1
State of Incorporation NH
Government P.O.C.
First Name SCOTT
Last Name SOUCY
Email Address managedcare.credentialing@genesishcc.com
US Phone 9788065805

Address on File
Street Address1 200 BRICKSTONE SQUARE
City ANDOVER
State MA
Zip/Postalcode 1810-0
Alt. Gov. P.O.C.
First Name JOAN
Last Name LYKE
Email Address managedcare.credentialing@genesishcc.com
US Phone 2034940814

Address on File
Street Address2 200 BRICKSTONE SQUARE
Line 2 SUITE 301
City ANDOVER
State MA
Zip/Postalcode 01810
Past Performance P.O.C.
First Name SCOTT
Last Name SOUCY
Title N/A
Email Address Scott.Soucy@GenesisHCC.com
US Phone 9788065805

Address on File
Street Address3 200 BRICKSTONE SQUARE, STE. 301
Line 2 SUITE 301
City ANDOVER
State MA
Zip/Postalcode 01810
Alt Past Perfocmane P.O.C.
First Name SCOTT
Last Name SOUCY
Title N/A
Email Address andrew.soucy@genesishcc.com
US Phone 9788065805

Address on File
Street Address4 200 BRICKSTONE SQUARE
City ANDOVER
State MA
Zip/Postalcode 01810-0
Electronic P.O.C.
First Name SCOTT
Last Name SOUCY
Email Address managedcare.credentialing@genesishcc.com
US Phone 9788065805

Address on File
Street Address5 200 BRICKSTONE SQUARE
City ANDOVER
State MA
Zip/Postalcode 01810-0
NAICS Information
NAICS Codes
Disaster Response Codes
Disaster Response Codes
N/A
PSC Codes
PSC Codes