Provider Demographics
NPI:1255322152
Name:GENESYS HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:GENESYS HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:GOLDLYNN
Authorized Official - Last Name:NANKIL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:757-961-5243
Mailing Address - Street 1:6363 CENTER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4103
Mailing Address - Country:US
Mailing Address - Phone:757-961-5243
Mailing Address - Fax:757-961-5253
Practice Address - Street 1:6363 CENTER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4103
Practice Address - Country:US
Practice Address - Phone:757-961-5243
Practice Address - Fax:757-961-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04-241251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010056721Medicaid
VA010105188Medicaid
VA010105188Medicaid