Genesis Adult Care, LLC

Organization Active NPI Exclusive Provider Organization · Saint Louis, MO

NPI 1144596263 · NPPES record last updated Mar 23, 2012

Key facts

NPI
1144596263
Entity type
Organization (NPI type 2)
Primary specialty
Exclusive Provider Organization 302F00000X
License
1007 (MO)
Legal business name
GENESIS ADULT CARE, LLC
Practice address
8420 Olive Blvd
Saint Louis, MO 63132-2816
Phone
(314) 989-1002
Fax
(866) 891-1631
NPI assigned
Mar 23, 2012
Organization subpart
No

Authorized official

Name
June Walker, R.N.
Title
Director
Phone
(314) 989-1002

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Genesis Adult Care LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 1007 MO Yes

Addresses

Primary practice location

8420 Olive Blvd
Saint Louis, MO 63132-2816

Mailing address

8420 Olive Blvd
Saint Louis, MO 63132-2816
Phone (314) 989-1002

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Exclusive Provider Organization in Missouri

Sources for this page

Verify at the official NPI Registry.