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General NPI Number Information
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NPI Number | 1083974612
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Entity Type | Organization
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Legal Business Name | GENESIS HOME HEALTH INC
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | HATO REY PLZ 200 AVE JESUS T PINEDO APT 21J
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City | SAN JUAN
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State | PR
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Zip | 00918-4109
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Country | US
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Telephone | 956-740-0106
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Fax |
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Provider Business Mailing Address
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Address Line | COND HATO REY PLAZA 200 AVE JESUS T PINEDO APT 21J
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 956-740-0106
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. PATRICIA GUAJARDO
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Credential | REGISTERED NURSE
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Telephone | 956-740-0106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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