| Genesis Llc | |
|
1007 W Broadway Ave Minneapolis MN 55411-2503 | |
| (952) 221-9987 | |
| (612) 486-8694 |
| Full Name | Genesis Llc |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 1007 W Broadway Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Wilma Denise King (PRESIDENT) |
| Authorized Official Contact | 6124089084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Llc 2143 Albemarle Ct N Roseville MN 55113-6677 Ph: (952) 221-9987 | Genesis Llc 1007 W Broadway Ave Minneapolis MN 55411-2503 Ph: (952) 221-9987 |
| NPI Number | 1174380463 |
|---|---|
| Provider Enumeration Date | 03/04/2024 |
| Last Update Date | 03/04/2024 |
| Certification Date | 03/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174380463 | NPI | - | NPPES |
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