NPI 1831974955
Genesis Adult Family Home LLC
Practice location
- Address
- 3315 W Burgundy CT, Mequon, WI 53092-5202
- Phone
- (262) 853-1344
Authorised official
- Name
- Wanda Boone
- Title
- Director
- Phone
- (262) 853-1344
Registered specialties (4)
Mental Illness Intermediate Care Facility
Primary
Nursing Care Agency
Nursing Facility/Intermediate Care Facility
Pediatric Skilled Nursing Facility
Registry record
- NPI
- 1831974955
- Entity type
- Organization
- NPI issued
- 28 Aug 2023
- Record last updated
- 28 Aug 2023
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.