Provider Demographics
NPI:1003618216
Name:GENESIS HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:GENESIS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARRAH
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-464-9780
Mailing Address - Street 1:11532 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6856
Mailing Address - Country:US
Mailing Address - Phone:317-464-9780
Mailing Address - Fax:
Practice Address - Street 1:11532 LONG LAKE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-6856
Practice Address - Country:US
Practice Address - Phone:317-464-9780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care