Provider Demographics
NPI:1447836820
Name:GENESISXXIV, LLC
Entity type:Organization
Organization Name:GENESISXXIV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASKEW
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:724-512-5438
Mailing Address - Street 1:841 23RD ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2784
Mailing Address - Country:US
Mailing Address - Phone:724-512-5438
Mailing Address - Fax:724-512-5442
Practice Address - Street 1:841 23RD ST STE 2
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2784
Practice Address - Country:US
Practice Address - Phone:724-512-5438
Practice Address - Fax:724-512-5442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health