Healthcare Provider Details

I. General information

NPI: 1720904642
Provider Name (Legal Business Name): GENEUSCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 WATERWAYS PKWY S
RICHMOND HILL GA
31324-8603
US

IV. Provider business mailing address

325 WATERWAYS PKWY S
RICHMOND HILL GA
31324-8603
US

V. Phone/Fax

Practice location:
  • Phone: 912-445-5043
  • Fax:
Mailing address:
  • Phone: 912-445-5043
  • 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: ROSELINE SHAW
Title or Position: MANAGING MEMBER/ADMINISTRATOR
Credential:
Phone: 908-239-7491