Provider Demographics
NPI:1780285247
Name:GENUINE HOME CARE LLC
Entity type:Organization
Organization Name:GENUINE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDILLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-577-5957
Mailing Address - Street 1:190 BATES ST STE 2-3
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7329
Mailing Address - Country:US
Mailing Address - Phone:571-577-5957
Mailing Address - Fax:
Practice Address - Street 1:190 BATES ST STE 2-3
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7329
Practice Address - Country:US
Practice Address - Phone:571-577-5957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care