Provider Demographics
NPI:1366649436
Name:GENESIS NURSES LLC
Entity Type:Organization
Organization Name:GENESIS NURSES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-670-3715
Mailing Address - Street 1:8925 ZANZIBAR LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1249
Mailing Address - Country:US
Mailing Address - Phone:763-670-3715
Mailing Address - Fax:763-494-3715
Practice Address - Street 1:8925 ZANZIBAR LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-1249
Practice Address - Country:US
Practice Address - Phone:763-670-3715
Practice Address - Fax:763-494-3715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health