Provider Demographics
NPI:1952940728
Name:GENERATIONS PROVIDER SERVICES LLC
Entity Type:Organization
Organization Name:GENERATIONS PROVIDER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMDARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-210-1785
Mailing Address - Street 1:12633 MEMORIAL DR #242 UNIT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:318-210-1785
Mailing Address - Fax:
Practice Address - Street 1:12633 MEMORIAL DR #242 UNIT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:318-210-1785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty