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General NPI Number Information
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NPI Number | 1710118443
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Entity Type | Organization
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Legal Business Name | GENESIS HEALTH SERVICES,INC.
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 2542 W 3RD ST SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90057-1929
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Country | US
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Telephone | 213-382-8761
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Fax | 213-382-8923
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Provider Business Mailing Address
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Address Line | 2542 W 3RD ST SUITE B
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City | LOS ANGELES
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State | CA
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Zip | 90057-1929
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Country | US
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Telephone | 213-382-8761
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Fax | 213-382-8923
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MRS. MARIA THERESA ORDONEZ QUEJA
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Credential | RN
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Telephone | 213-382-8761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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