Provider Demographics
NPI:1366196917
Name:GENESIS HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:GENESIS HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIVELLE
Authorized Official - Middle Name:O
Authorized Official - Last Name:SPEED-STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-226-4879
Mailing Address - Street 1:901 NW 8TH AVE STE B8
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-5089
Mailing Address - Country:US
Mailing Address - Phone:352-226-4876
Mailing Address - Fax:
Practice Address - Street 1:901 NW 8TH AVE STE B8
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5089
Practice Address - Country:US
Practice Address - Phone:352-226-4876
Practice Address - Fax:352-557-0250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS HOME CARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory