Provider Demographics
NPI:1912635624
Name:GEN NEXT ENTERPRISES LLC
Entity Type:Organization
Organization Name:GEN NEXT ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-471-6935
Mailing Address - Street 1:1602 E EBONY PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2236
Mailing Address - Country:US
Mailing Address - Phone:520-471-6935
Mailing Address - Fax:
Practice Address - Street 1:1602 E EBONY PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-2236
Practice Address - Country:US
Practice Address - Phone:520-471-6935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty