Provider Demographics
NPI:1588094767
Name:GENESIS CASE MANAGEMENT SERVICES, CORP.
Entity type:Organization
Organization Name:GENESIS CASE MANAGEMENT SERVICES, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:TONY
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, RN, BSN
Authorized Official - Phone:954-695-1258
Mailing Address - Street 1:540 NW 165TH STREET RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6304
Mailing Address - Country:US
Mailing Address - Phone:786-953-4612
Mailing Address - Fax:786-953-8534
Practice Address - Street 1:540 NW 165TH STREET RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6304
Practice Address - Country:US
Practice Address - Phone:786-953-4612
Practice Address - Fax:786-953-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management