Provider Demographics
NPI:1285003939
Name:GENESIS HOME CARE SERVICES
Entity Type:Organization
Organization Name:GENESIS HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DANNAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:864-534-3677
Mailing Address - Street 1:880 S PLEASANTBURG DR
Mailing Address - Street 2:SUITE 2E OFFICE A
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2422
Mailing Address - Country:US
Mailing Address - Phone:864-534-3677
Mailing Address - Fax:864-370-7201
Practice Address - Street 1:880 S PLEASANTBURG DR
Practice Address - Street 2:SUITE 2E OFFICE A
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2422
Practice Address - Country:US
Practice Address - Phone:864-534-3677
Practice Address - Fax:864-370-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health