Provider Demographics
NPI:1679065551
Name:THE GENESIS PROJECT USA
Entity type:Organization
Organization Name:THE GENESIS PROJECT USA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SHANTE'
Authorized Official - Last Name:HAUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-339-0601
Mailing Address - Street 1:16366 PAITER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77053-4420
Mailing Address - Country:US
Mailing Address - Phone:832-339-0601
Mailing Address - Fax:855-324-1505
Practice Address - Street 1:16366 PAITER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77053
Practice Address - Country:US
Practice Address - Phone:832-339-0601
Practice Address - Fax:855-324-1505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE GENESIS PROJECT USA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-05
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No347C00000XTransportation ServicesPrivate Vehicle
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No253Z00000XAgenciesIn Home Supportive Care