Provider Demographics
NPI:1417526781
Name:GENEVA HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:GENEVA HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:614-779-8821
Mailing Address - Street 1:5424 RAVINE BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-3157
Mailing Address - Country:US
Mailing Address - Phone:614-779-8821
Mailing Address - Fax:614-215-9820
Practice Address - Street 1:5424 RAVINE BLUFF CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-3157
Practice Address - Country:US
Practice Address - Phone:614-779-8821
Practice Address - Fax:614-215-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care