Provider Demographics
NPI:1972357218
Name:GENESIS ELITE CARE LLC
Entity Type:Organization
Organization Name:GENESIS ELITE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINASSO
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:713-340-8010
Mailing Address - Street 1:700 W CAVALCADE ST APT 2201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-2056
Mailing Address - Country:US
Mailing Address - Phone:713-340-8010
Mailing Address - Fax:
Practice Address - Street 1:700 W CAVALCADE ST APT 2201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-2056
Practice Address - Country:US
Practice Address - Phone:713-340-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health