Provider Demographics
NPI:1750120903
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:LULU
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-546-9645
Mailing Address - Street 1:9915 CYPRESS CREEK PKWY APT 304
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6052
Mailing Address - Country:US
Mailing Address - Phone:346-669-0869
Mailing Address - Fax:
Practice Address - Street 1:9630 BIRSAY ST
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4336
Practice Address - Country:US
Practice Address - Phone:346-669-0869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care