Provider Demographics
NPI:1992511539
Name:GENESIS SOLUTIONS OF TENNESSEE INC
Entity type:Organization
Organization Name:GENESIS SOLUTIONS OF TENNESSEE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OTOME
Authorized Official - Middle Name:T
Authorized Official - Last Name:JAKPOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-705-6765
Mailing Address - Street 1:2805 FOSTER AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-5352
Mailing Address - Country:US
Mailing Address - Phone:615-705-6765
Mailing Address - Fax:
Practice Address - Street 1:2805 FOSTER AVE STE 204
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-5352
Practice Address - Country:US
Practice Address - Phone:615-705-6765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS SOLUTIONS OF TENNESSEE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care