Provider Demographics
NPI:1083154884
Name:GENESIS HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:GENESIS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:BOADI
Authorized Official - Last Name:YEBOAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-678-5259
Mailing Address - Street 1:617A CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1966
Mailing Address - Country:US
Mailing Address - Phone:973-678-5259
Mailing Address - Fax:973-677-1563
Practice Address - Street 1:617A CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1966
Practice Address - Country:US
Practice Address - Phone:973-678-5259
Practice Address - Fax:973-677-1563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0174900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health