Healthcare Provider Details

I. General information

NPI: 1528076312
Provider Name (Legal Business Name): GENESIS HOMEHEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 N BALLENGER HWY STE F-3
FLINT MI
48504-7500
US

IV. Provider business mailing address

1207 N BALLENGER HWY STE F-3
FLINT MI
48504-7500
US

V. Phone/Fax

Practice location:
  • Phone: 810-235-5115
  • Fax: 810-235-5115
Mailing address:
  • Phone: 810-235-5115
  • Fax: 810-235-5115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. GAVINA MORALES TECSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 586-899-6749