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General NPI Number Information
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NPI Number | 1669338562
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Entity Type | Organization
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Legal Business Name | GENESIS CARE SERVICES,LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 12 WILLOW CREEK CT
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City | PARKVILLE
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State | MD
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Zip | 21234-8715
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Country | US
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Telephone | 940-279-3119
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Fax |
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Provider Business Mailing Address
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Address Line | 12 WILLOW CREEK CT
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City | PARKVILLE
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State | MD
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Zip | 21234-8715
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Country | US
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Telephone | 940-279-3119
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | AUSTIN AJUZIE MARK
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Credential | LVN
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Telephone | 314-603-4194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number |
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License Number State |
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