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GENESIS COMPANION SERVICES LLC NPI 1770977290


NPI Information

NPI: 1770977290
Provider Name: GENESIS COMPANION SERVICES LLC
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
6501 ARLINGTON EXPY STE B105
JACKSONVILLE, FL
ZIP 32211
Phone: (904) 675-0778
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GENESIS COMPANION SERVICES LLC is a day training developmentally disabled services in Jacksonville, FL. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. GENESIS COMPANION SERVICES LLC NPI is 1770977290. The provider is registered as an organization entity type.

The provider's business location address is:

6501 ARLINGTON EXPY STE B105
JACKSONVILLE, FL
ZIP 32211-810
Phone: (904) 675-0778
Fax: (904) 212-2591

The provider's authorized official is Tanisa Scippio .
The authorized official title is Owner and has the following contact phone number (904) 405-5614.

The enumeration date for this NPI number is 3/23/2015 and was last updated on 1/13/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthFLORIDANo
2251E00000XHome HealthNo
3251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1014096300MEDICAIDFLORIDA

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: 4/28/2024

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