MEDICARE: GENESIS SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1093475345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	6166 S SANDHILL RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6166 S SANDHILL RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3216
Country	:	US
Telephone Number	:	702-308-0809
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHINYU KEMPER
Credential	:	CPA
Telephone Number	:	702-308-0809

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	12/28/2021

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