Provider Demographics
NPI:1114335247
Name:GENERATIONS HOME CARE
Entity Type:Organization
Organization Name:GENERATIONS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:602-595-4663
Mailing Address - Street 1:2111 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1516
Mailing Address - Country:US
Mailing Address - Phone:602-595-4663
Mailing Address - Fax:866-236-7997
Practice Address - Street 1:2111 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1516
Practice Address - Country:US
Practice Address - Phone:602-595-4663
Practice Address - Fax:866-236-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0000001253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care