Organization
GENESIS HEALTH AT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SUKU JEZREEL (PRESIDENT)
(512) 516-3466
Entity
Organization
Contact information
Practice address
13785 RESEARCH BLVD STE 125, AUSTIN, TX 78750-1826
(512) 516-3466
(877) 554-0690
Mailing address
3122 ARGENTO PL, CEDAR PARK, TX 78613-4357
(512) 516-3466
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
08/22/2021
Last updated
11/05/2024
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