Genesis Adult Care, LLC

Organization Active NPI Health Maintenance Organization · Saint Louis, MO

NPI 1235397704 · NPPES record last updated May 30, 2008

Key facts

NPI
1235397704
Entity type
Organization (NPI type 2)
Primary specialty
Health Maintenance Organization 302R00000X
License
763 (MO)
Legal business name
GENESIS ADULT CARE, LLC
Practice address
8405 Olive Blvd
Saint Louis, MO 63132-2815
Phone
(314) 989-1002
NPI assigned
May 30, 2008
Organization subpart
No

Authorized official

Name
June Walker
Title
Owner
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)

Locations

8405 Olive Blvd
Saint Louis, MO 63132
Phone (314) 989-1002

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 763 MO Yes

Addresses

Primary practice location

8405 Olive Blvd
Saint Louis, MO 63132-2815

Mailing address

8405 Olive Blvd
Saint Louis, MO 63132-2815
Phone (314) 989-1002

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Health Maintenance Organization in Missouri

Sources for this page

Verify at the official NPI Registry.