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GENESIS AT HOME LLC NPI 1346855848


NPI Information

NPI: 1346855848
Provider Name: GENESIS AT HOME LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
1027 W CALYPSO CT
GILBERT, AZ
ZIP 85233
Phone: (651) 246-7242
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GENESIS AT HOME LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Gilbert, AZ. 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 AT HOME LLC NPI is 1346855848. The provider is registered as an organization entity type.

The provider's business location address is:

1027 W CALYPSO CT
GILBERT, AZ
ZIP 85233-769
Phone: (651) 246-7242

The provider's authorized official is Anthony Aghenta .
The authorized official title is President and has the following contact phone number (651) 246-7242.

The enumeration date for this NPI number is 9/11/2020 and was last updated on 9/11/2020.


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

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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