Organization · Type 2 NPI
Genesis Corporation
Intellectual Disabilities Intermediate Care Facility · San Lorenzo, CA
NPI number
1023004561
Active
Practice location
17096 Via Flores
San Lorenzo, CA 94580-2915
Fax (510) 276-7802
Mailing address
PO Box 626
Pismo Beach, CA 93448-0626
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1023004561
Genesis Corporation's National Provider Identifier is 1023004561, issued on Sep 20, 2005. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in San Lorenzo, CA. The record was last updated on Aug 22, 2020.