MEDICARE: GENESIS SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency
3	251E00000X	Home Health Agency
4	251S00000X	Community/Behavioral Health Agency
5	253Z00000X	In Home Supportive Care Agency
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
7	261QM0855X	Adolescent and Children Mental Health Clinic/Center
8	310400000X	Assisted Living Facility
9	343900000X	Non-emergency Medical Transport (VAN)
10	347E00000X	Transportation Broker
11	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1306691878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	10304 NEW HAMPSHIRE AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1413
Country	:	US
Telephone Number	:	202-573-3282
Fax Number	:

Provider Business Practice Location Address
First Line	:	10304 NEW HAMPSHIRE AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1413
Country	:	US
Telephone Number	:	202-573-3282
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. AURELIEN FOTO
Credential	:
Telephone Number	:	202-573-3282

Provider Enumeration Date	:	04/18/2024
Last Update Date	:	04/18/2024

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Directions to “GENESIS SUPPORT SERVICES LLC ” Practice Location

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