MEDICARE: GENESIS INVESTMENTS 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	311Z00000X	Custodial Care Facility

General Provider Information

NPI Number	:	1366985038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS INVESTMENTS LLC

Provider Business Mailing Address
First Line	:	11713 BECKTON ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071
Country	:	US
Telephone Number	:	972-408-8041
Fax Number	:

Provider Business Practice Location Address
First Line	:	11713 BECKTON ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071
Country	:	US
Telephone Number	:	972-408-8041
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MERCY KURIA
Credential	:
Telephone Number	:	972-408-8041

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	11/29/2016

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Directions to “GENESIS INVESTMENTS LLC ” Practice Location

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