GENESIS ENTERPRISES INC NPI 1871631283

NPI Information

NPI: 1871631283
Provider Name: GENESIS ENTERPRISES INC

Other Name: GENESIS HOUSE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
350 SYCAMORE RD
GENOA, IL
ZIP 60135
Phone: (815) 784-5146
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GENESIS ENTERPRISES INC is an intermediate care facility mentally retarded in Genoa, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. GENESIS ENTERPRISES INC NPI is 1871631283. The provider is registered as an organization entity type.
The provider Other Name Is Genesis House.

The provider's business location address is:

350 SYCAMORE RD
GENOA, IL
ZIP 60135-361
Phone: (815) 784-5146
Fax: (815) 784-2594

The provider's authorized official is Desiree Alicia Henderson Sawyer .
The authorized official title is Executive Director and has the following contact phone number (815) 784-3712.

The enumeration date for this NPI number is 2/1/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		0031906	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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