Provider Demographics
NPI:1467992008
Name:GENESIS HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:GENESIS HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SSEKAJJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-579-5875
Mailing Address - Street 1:PO BOX 460173
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80046-0173
Mailing Address - Country:US
Mailing Address - Phone:800-579-7875
Mailing Address - Fax:
Practice Address - Street 1:6140 S GUN CLUB RD
Practice Address - Street 2:STE K6 138
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1373
Practice Address - Country:US
Practice Address - Phone:800-579-7875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health