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General NPI Number Information
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NPI Number | 1790096865
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Entity Type | Organization
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Legal Business Name | GENUINE HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 7420 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60645-1707
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Country | US
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Telephone | 773-338-8606
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Fax | 773-961-7599
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Provider Business Mailing Address
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Address Line | 7420 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60645-1707
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Country | US
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Telephone | 773-338-8606
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Fax | 773-961-7599
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MARLENA BANSA
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Credential |
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Telephone | 773-338-8603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 3000609
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License Number State | IL
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