Provider Demographics
NPI:1902837131
Name:GENESIS NATIONAL HEALTHCARE, INC.
Entity Type:Organization
Organization Name:GENESIS NATIONAL HEALTHCARE, INC.
Other - Org Name:GENESIS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-933-0427
Mailing Address - Street 1:8323 SOUTHWEST FWY
Mailing Address - Street 2:#100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1615
Mailing Address - Country:US
Mailing Address - Phone:713-933-0429
Mailing Address - Fax:
Practice Address - Street 1:8323 SOUTHWEST FWY
Practice Address - Street 2:#100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1615
Practice Address - Country:US
Practice Address - Phone:713-933-0429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008554251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679416Medicare Oscar/Certification