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General NPI Number Information
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NPI Number | 1194146829
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Entity Type | Organization
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Legal Business Name | GENESIS NATIONAL ALLIANCE LLC
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Dates
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Enumeration Date | 12/24/2013
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 4390 MAHONING AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44515
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Country | US
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Telephone | 330-318-3234
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Fax | 330-319-7889
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Provider Business Mailing Address
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Address Line | 4390 MAHONING AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44515
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Country | US
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Telephone | 330-318-3234
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Fax | 330-319-7889
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL ROBERT SENCHAK
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Credential |
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Telephone | 330-318-3234
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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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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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