Healthcare Provider Details

I. General information

NPI: 1972357218
Provider Name (Legal Business Name): GENESIS ELITE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 INDIAN WELLS DR
MANVEL TX
77578-3387
US

IV. Provider business mailing address

46 INDIAN WELLS DR
MANVEL TX
77578-3387
US

V. Phone/Fax

Practice location:
  • Phone: 713-340-8010
  • Fax:
Mailing address:
  • Phone: 713-340-8010
  • Fax: 832-342-9892

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
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JESSE MINASSO
Title or Position: OPERATOR
Credential: RRT
Phone: 713-340-8010