Provider Demographics
NPI:1942619846
Name:GENUINE CARE, LLC
Entity Type:Organization
Organization Name:GENUINE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:A'DIAMOND
Authorized Official - Middle Name:MONAE
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-239-2855
Mailing Address - Street 1:3952 TRIPLE CROWN DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3404
Mailing Address - Country:US
Mailing Address - Phone:314-239-2855
Mailing Address - Fax:314-787-4440
Practice Address - Street 1:3952 TRIPLE CROWN DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-3404
Practice Address - Country:US
Practice Address - Phone:314-239-2855
Practice Address - Fax:314-787-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1399141251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health