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General NPI Number Information
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NPI Number | 1568175347
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Entity Type | Organization
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Legal Business Name | GENESIS PARTNERS II
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 108 E STEPHENSON AVE STE C
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City | HARRISON
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State | AR
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Zip | 72601-4312
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Country | US
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Telephone | 870-751-7512
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Fax |
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Provider Business Mailing Address
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Address Line | 324 N 48TH ST
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City | SPRINGDALE
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State | AR
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Zip | 72762-3746
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Country | US
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Telephone | 479-246-0140
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CODY GARRISON
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Credential |
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Telephone | 870-404-9300
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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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