# GENESIS NURSING AGENCY LLC

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

## Provider details

- **NPI number:** 1447696349
- **Authorized official:** FERESIE A. ISOME (OWNER)
- **Authorized official phone:** (254) 371-0934

## Contact information

- **Practice address:** 509 W. LIBRA DR., KILLEEN, TX 76542-5771
- **Practice address phone:** (254) 634-1003
- **Practice address fax:** (254) 634-1005
- **Mailing address:** 509 W. LIBRA DR., KILLEEN, TX 76542-5771
- **Mailing address phone:** (254) 634-1003
- **Mailing address fax:** (254) 634-1005

## Taxonomy

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

## Other

- **Enumeration date:** 05/17/2013
- **Last updated:** 11/19/2013