Healthcare Provider Details

I. General information

NPI: 1790551158
Provider Name (Legal Business Name): GENUINE LOVE STAFFING AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 WHITECLIFF DR
JONESBORO AR
72405-8145
US

IV. Provider business mailing address

5820 WHITECLIFF DR
JONESBORO AR
72405-8145
US

V. Phone/Fax

Practice location:
  • Phone: 870-549-7376
  • Fax:
Mailing address:
  • Phone: 870-549-7376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ASIA JAKIA LOVE
Title or Position: CEO/ORGANIZER
Credential:
Phone: 870-549-7376