Provider Demographics
NPI:1417344284
Name:GENESIS STAFFING SERVICES, LLC
Entity Type:Organization
Organization Name:GENESIS STAFFING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RN, PHR, CHCR
Authorized Official - Phone:410-494-8569
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-832-7761
Mailing Address - Fax:410-832-7789
Practice Address - Street 1:515 FAIRMOUNT AVE
Practice Address - Street 2:8TH FLOOR
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-832-7761
Practice Address - Fax:410-832-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHCSA1101002251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health