GENESIS DEVELOPMENT NPI 1942327283

NPI Information

NPI: 1942327283
Provider Name: GENESIS DEVELOPMENT
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
401 W MCKINLEY ST
JEFFERSON, IA
ZIP 50129
Phone: (515) 386-3017
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GENESIS DEVELOPMENT is a community based residential treatment facility, intellectual and/or developmental disabilities in Jefferson, IA. 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 DEVELOPMENT NPI is 1942327283. The provider is registered as an organization entity type.

The provider's business location address is:

401 W MCKINLEY ST
JEFFERSON, IA
ZIP 50129-421
Phone: (515) 386-3017
Fax: (515) 386-4642

The provider's authorized official is Terry L Johnson .
The authorized official title is Ceo and has the following contact phone number (515) 386-3017.

The enumeration date for this NPI number is 3/23/2007 and was last updated on 5/5/2010.

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	Primary
1	253Z00000X	In Home Supportive Care		No
2	251C00000X	Day Training, Developmentally Disabled Services		No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness		No
4	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		No
5	251S00000X	Community/Behavioral Health		No
6	3104A0630X	Assisted Living Facility	Assisted Living, Behavioral Disturbances	No
7	3104A0625X	Assisted Living Facility	Assisted Living, Mental Illness	No
8	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0400619	MEDICAID	IOWA
2	4741769	MEDICAID	IOWA
3	0400617	MEDICAID	IOWA
4	9741769	MEDICAID	IOWA
5	0741769	MEDICAID	IOWA
6	0748996	MEDICAID	IOWA
7	7741769	MEDICAID	IOWA
8	1748996	MEDICAID	IOWA
9	0402652	MEDICAID	IOWA
10	2741769	MEDICAID	IOWA
11	5741769	MEDICAID	IOWA
12	0402653	MEDICAID	IOWA
13	3741769	MEDICAID	IOWA
14	6741769	MEDICAID	IOWA
15	0400620	MEDICAID	IOWA
16	0400621	MEDICAID	IOWA
17	1741769	MEDICAID	IOWA
18	2748996	MEDICAID	IOWA
19	8741769	MEDICAID	IOWA
20	0400618	MEDICAID	IOWA

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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