Provider Demographics
NPI:1437879798
Name:GENESIS HOME HEALTHCARE, LIMITED LIABILITY COMPANY, JACKSO
Entity type:Organization
Organization Name:GENESIS HOME HEALTHCARE, LIMITED LIABILITY COMPANY, JACKSO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-204-4325
Mailing Address - Street 1:10175 FORTUNE PKWY
Mailing Address - Street 2:UNIT 804
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6751
Mailing Address - Country:US
Mailing Address - Phone:813-641-0500
Mailing Address - Fax:844-718-0076
Practice Address - Street 1:10175 FORTUNE PKWY
Practice Address - Street 2:UNIT 804
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6751
Practice Address - Country:US
Practice Address - Phone:904-204-4325
Practice Address - Fax:844-718-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty