Organization
GENESIS CDS, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY ALLEN (OWNER)
(314) 389-1943
Entity
Organization
Contact information
Practice address
4711 GOODFELLOW BLVD, SAINT LOUIS, MO 63120-1516
(314) 389-1943
(314) 389-7117
Mailing address
4711 GOODFELLOW BLVD, SAINT LOUIS, MO 63120-1516
(314) 389-1943
(314) 389-7117
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3747P1801X
—
MO
Enumeration date
04/16/2014
Last updated
04/16/2014
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