Provider Demographics
NPI:1083974612
Name:GENESIS HOME HEALTH INC
Entity Type:Organization
Organization Name:GENESIS HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAJARDO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:956-740-0106
Mailing Address - Street 1:COND HATO REY PLAZA
Mailing Address - Street 2:200 AVE JESUS T PINEDO APT 21J
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:956-740-0106
Mailing Address - Fax:
Practice Address - Street 1:HATO REY PLZ
Practice Address - Street 2:200 AVE JESUS T PINEDO APT 21J
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4109
Practice Address - Country:US
Practice Address - Phone:956-740-0106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health