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General NPI Number Information
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NPI Number | 1154258853
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Entity Type | Individual
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Provider Name | GENESIS MARIE DE LEON CNA, RBT
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Gender | Female
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 2709 BEACON ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6115
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Country | US
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Telephone | 310-482-7437
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Fax |
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Provider Business Mailing Address
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Address Line | 2709 BEACON ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6115
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Country | US
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Telephone | 310-482-7437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | NA.00822081
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1404687
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License Number State | CO
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