NPI 1003887639
Genesis Development
Practice location
- Address
- 401 W McKinley St, Jefferson, IA 50129-1421
- Phone
- (515) 386-3017
- Fax
- (515) 386-4642
- Mailing address
- PO Box 438, Jefferson, IA 50129-0438
Authorised official
- Name
- Terry Johnson
- Title
- Ceo
- Phone
- (515) 386-3017
Registered specialties (8)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Developmentally Disabled Services Day Training Agency
Community/Behavioral Health Agency
Assisted Living Facility (Mental Illness)
Assisted Living Facility (Behavioral Disturbances)
Adult Care Home Facility
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Mental Illness Community Based Residential Treatment Facility
Registry record
- NPI
- 1003887639
- Entity type
- Organization
- NPI issued
- 31 Jan 2006
- Record last updated
- 5 May 2010
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.