Provider Demographics
NPI:1265218044
Name:GENTA HOME CARE
Entity type:Organization
Organization Name:GENTA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAREKEGN
Authorized Official - Middle Name:
Authorized Official - Last Name:TABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-906-1818
Mailing Address - Street 1:1 BYARS CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-4100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 BYARS CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-4100
Practice Address - Country:US
Practice Address - Phone:608-906-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care