Provider Demographics
NPI:1215648449
Name:GENESIS HOME HEALTH AGENCY INC
Entity type:Organization
Organization Name:GENESIS HOME HEALTH AGENCY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-837-9022
Mailing Address - Street 1:2000 E LAMAR BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-7361
Mailing Address - Country:US
Mailing Address - Phone:817-518-9022
Mailing Address - Fax:817-476-8002
Practice Address - Street 1:2000 E LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7346
Practice Address - Country:US
Practice Address - Phone:817-837-0977
Practice Address - Fax:817-476-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPERSONALCAREMedicaid
TXHOMEMAKEROtherHOME CARE
TXCOMPANIONOtherHOME CARE
TXPERSONALCAREOtherHOME CARE