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Organization
GENESIS INCORPORATED
Active
Organization
GENESIS INCORPORATED
Active
Other names
DivinityCares, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDWINA HARMON BUSHNELL (CHIEF EXECUTIVE OFFICER)
(337) 436-3161
Entity
Organization
Contact information
Practice address
1725 OPELOUSAS ST, LAKE CHARLES, LA 70601-2560
(337) 436-3161
(337) 436-3132
Mailing address
1725 OPELOUSAS ST, LAKE CHARLES, LA 70601-2560
(337) 436-3161
(337) 436-3132
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
251G00000X
Community Based Hospice Care Agency
—
LA
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
302F00000X
Exclusive Provider Organization
—
LA
332BN1400X
Nursing Facility Supplies (DME)
—
NULL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
NULL
332H00000X
Eyewear Supplier
—
NULL
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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