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General NPI Number Information
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NPI Number | 1881859544
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Entity Type | Organization
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Legal Business Name | GENESIS CARELINK
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 705 E SUNFLOWER ROAD
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City | CLEVELAND
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State | MS
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Zip | 38732-1888
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Country | US
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Telephone | 666-284-6092
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Fax | 662-846-0115
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Provider Business Mailing Address
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Address Line | 6341 HIGHWAY 51 N SUITE 6
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City | HORN LAKE
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State | MS
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Zip | 38637-2476
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Country | US
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Telephone | 662-393-3414
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Fax | 662-393-3474
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Authorized Official
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Title or Position | OWNER, ADMINISTRATOR
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Name | CHARLINE BRANDON MORRIS
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Credential | RN
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Telephone | 662-846-0922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 118
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License Number State | MS
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