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GENESIS MANOR LLC NPI 1972875318


NPI Information

NPI: 1972875318
Provider Name: GENESIS MANOR, LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
1560 KNOTT ST
LYNCHBURG, VA
ZIP 24502
Phone: (434) 237-2044
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GENESIS MANOR, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Lynchburg, VA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. GENESIS MANOR, LLC NPI is 1972875318. The provider is registered as an organization entity type.

The provider's business location address is:

1560 KNOTT ST
LYNCHBURG, VA
ZIP 24502-107
Phone: (434) 237-2044
Fax: (434) 237-2055

The provider's authorized official is Christina Smith Jackson .
The authorized official title is Records Manager/coowner and has the following contact phone number (434) 610-6132.

The enumeration date for this NPI number is 2/1/2012 and was last updated on 2/1/2012.


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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities1751VIRGINIAYes

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

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