Provider Demographics
NPI:1659156180
Name:GENESIS RECUPERATIVE CARE SERVICES,INC
Entity Type:Organization
Organization Name:GENESIS RECUPERATIVE CARE SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-864-2231
Mailing Address - Street 1:1036 W STOCKWELL ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90222-3321
Mailing Address - Country:US
Mailing Address - Phone:213-352-6038
Mailing Address - Fax:323-967-7300
Practice Address - Street 1:1036 W STOCKWELL ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90222-3321
Practice Address - Country:US
Practice Address - Phone:213-352-6038
Practice Address - Fax:323-967-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care