Provider Demographics
NPI:1841901147
Name:GENNCARE HOME AND HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:GENNCARE HOME AND HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN-LAING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-366-2522
Mailing Address - Street 1:6138 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-2915
Mailing Address - Country:US
Mailing Address - Phone:267-366-2522
Mailing Address - Fax:215-747-1021
Practice Address - Street 1:6138 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-2915
Practice Address - Country:US
Practice Address - Phone:267-366-2522
Practice Address - Fax:215-747-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care