NPI 1013231117

Genesis Community Resource Center

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Saint John, IN

Practice location

Address: 11616 Barberry CT, Saint John, IN 46373-9690
Phone: (708) 654-6324
Mailing address: 320 W Ridge Rd, Gary, IN 46408-2735

Authorised official

Name: Shanda Rena Evans
Title: Administrator
Phone: (219) 884-1402

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Indiana →

Registry record

NPI: 1013231117
Entity type: Organization
NPI issued: 17 Mar 2010
Record last updated: 17 Mar 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.