Organization
GENESIS IN HOME CARE LLC
Active
Parent organization
GENESIS IN HOME CARE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS IN HOME CARE LLC
Authorized official
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
251E00000X
Home Health Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029217357
—
MO
05
—
M285822805
—
MO
Enumeration date
09/29/2020
Last updated
09/29/2020
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