# GENESIS SUPORTIVE LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386022341
- **Authorized official:** XAVIER WARREN (ASSISTANT OFFICE SUPPORT)
- **Authorized official phone:** (414) 562-2567

## Contact information

- **Practice address:** 1545 N 7TH ST, MILWAUKEE, WI 53205-2347
- **Practice address phone:** (414) 562-2567
- **Practice address fax:** (414) 264-7778
- **Mailing address:** 1545 N 7TH ST, MILWAUKEE, WI 53205-2347
- **Mailing address phone:** (414) 562-2567
- **Mailing address fax:** (414) 264-7778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/11/2015
- **Last updated:** 05/11/2015