Provider Demographics
NPI:1366786162
Name:GENESIS HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GENESIS HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUERUBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:IGUBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-753-7626
Mailing Address - Street 1:2620 RUBY VISTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-3764
Mailing Address - Country:US
Mailing Address - Phone:775-753-7626
Mailing Address - Fax:
Practice Address - Street 1:1500 AVENUE F
Practice Address - Street 2:SUITE D
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-3506
Practice Address - Country:US
Practice Address - Phone:775-289-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS HOME HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-16
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7570HSB-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health