Provider Demographics
NPI:1578954988
Name:JENEVIEVE HOMECARE AND HOSPICE
Entity Type:Organization
Organization Name:JENEVIEVE HOMECARE AND HOSPICE
Other - Org Name:JENEVIEVE HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, RFA, CNA
Authorized Official - Phone:214-789-9138
Mailing Address - Street 1:1831 MOUNTAIN LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6379
Mailing Address - Country:US
Mailing Address - Phone:214-789-9138
Mailing Address - Fax:800-891-8582
Practice Address - Street 1:1831 MOUNTAIN LAUREL LN
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-6379
Practice Address - Country:US
Practice Address - Phone:214-789-9138
Practice Address - Fax:800-891-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016544251E00000X, 253Z00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health