Provider Demographics
NPI:1356690804
Name:GENO HEALTH SERVICES LLC
Entity type:Organization
Organization Name:GENO HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ASHU
Authorized Official - Last Name:NOJANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-891-3573
Mailing Address - Street 1:3560 SHILOH RD. NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144
Mailing Address - Country:US
Mailing Address - Phone:505-891-3573
Mailing Address - Fax:505-891-3573
Practice Address - Street 1:3560 SHILOH RD. NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144
Practice Address - Country:US
Practice Address - Phone:505-891-3573
Practice Address - Fax:505-891-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM12-00012932251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health