Provider Demographics
NPI:1821750118
Name:GENUINE CARING HEARTS CDS LLC
Entity Type:Organization
Organization Name:GENUINE CARING HEARTS CDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:QIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-498-5660
Mailing Address - Street 1:9191 W FLORISSANT AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1424
Mailing Address - Country:US
Mailing Address - Phone:314-498-5660
Mailing Address - Fax:314-455-3966
Practice Address - Street 1:9191 W FLORISSANT AVE STE 211
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1424
Practice Address - Country:US
Practice Address - Phone:314-498-5660
Practice Address - Fax:314-455-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health