Healthcare Provider Details

I. General information

NPI: 1386580728
Provider Name (Legal Business Name): GEN Z SUPPORT SERVICES L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 W BERKELEY RD
PHOENIX AZ
85037-4391
US

IV. Provider business mailing address

9171 W BERKELEY RD
PHOENIX AZ
85037-4391
US

V. Phone/Fax

Practice location:
  • Phone: 480-617-9990
  • Fax:
Mailing address:
  • Phone: 480-617-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN MASIMANGO
Title or Position: OWNER
Credential:
Phone: 480-617-9990