Provider Demographics
NPI:1528076312
Name:GENESIS HOMEHEALTH SERVICES LLC
Entity type:Organization
Organization Name:GENESIS HOMEHEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GAVINA
Authorized Official - Middle Name:MORALES
Authorized Official - Last Name:TECSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-899-6749
Mailing Address - Street 1:1207 N BALLENGER HWY STE F-3
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-7500
Mailing Address - Country:US
Mailing Address - Phone:810-235-5115
Mailing Address - Fax:810-235-5115
Practice Address - Street 1:1207 N BALLENGER HWY STE F-3
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-7500
Practice Address - Country:US
Practice Address - Phone:810-235-5115
Practice Address - Fax:810-235-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty