Genesis History Maker Community Development Corporation
Case Management in Killeen, TX. Organization (NPI-2).
NPI number1619874476
StatusActive
Last updated in NPPESOct 23, 2026
Details
- NPI
- 1619874476
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis History Maker Community Development Corporation
- Organization subpart
- No
- Enumeration date
- Oct 23, 2026
- Certification date
- Oct 21, 2026
- Last updated
- Oct 23, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251B00000X | Case Management | – | – | Yes |
| 305S00000X | Point of Service | – | – |
Practice location
708 E Elms RdKilleen, TX 76542-6032
Phone 866-259-9691
Mailing address
708 E Elms RdKilleen, TX 76542-6032
Phone 866-259-9691
Authorized official
Antonia Martinez Revell
President
8662599691
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