NPI 1023004561

Genesis Corporation

Organisation Intellectual Disabilities Intermediate Care Facility San Lorenzo, CA

Practice location

Address: 17096 Via Flores, San Lorenzo, CA 94580-2915
Phone: (510) 276-8442
Fax: (510) 276-7802
Mailing address: PO Box 626, Pismo Beach, CA 93448-0626

Authorised official

Name: Pamela Graham
Title: Controller
Phone: (805) 489-9472

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in California →

Registry record

NPI: 1023004561
Entity type: Organization
NPI issued: 20 Sep 2005
Record last updated: 22 Aug 2020

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.