<Unavail>

LBN: Genesis Corporation
<Unavail> is an health care organization with primary practice located at 17096 Via Flores , San Lorenzo CA 94580-2915. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Genesis Corporation can be contacted via phone (510) 276-8442, or through Graham, Pamela via phone (805) 489-9472.

Contact Information

Primary practice address
17096 Via Flores San Lorenzo CA 94580-2915
Phone: (510) 276-8442
Fax: (510) 276-7802
Website:
Map and Directions
Authorized official contact:
Name: Graham, Pamela
Phone: (805) 489-9472

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X California

Profile Details

NPI number 1023004561
LBN Legal business name Genesis Corporation
DBA Doing business as <Unavail>
Authorized official Graham, Pamela
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2005
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023004561 NPPES
California MEDICAID LTC60739F

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