GENESIS HOMES OF JACKSON INC. (NPI# 1225366313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225366313 |
| Entity Type | Organization |
| Organization Name | GENESIS HOMES OF JACKSON INC. |
| Practice Address |
6853 Hague Ave Jackson MI 49201-8334 |
| Practice Telephone | 5177823280 |
| Mailing Telephone | 5177823280 |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |
| Authorized Official Name | MS. SHELLY S KEINATH (PRESIDENT) |
| Authorized Official Telephone | 5177823280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | AF380246001 | MI | Residential Treatment Facilities |
| Street Address |
6853 HAGUE AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-8334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922650365 | Enable Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12 Thompson Bridge Rd, Jackson, NJ 08527-4618 | 2019-07-16 |
| 1912383779 | Mississippi Health Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 W Amite St, Jackson, MS 39201-1203 | 2015-08-04 |
| 1053742684 | Building Futures, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 220 Mcdowell Park Cir, Jackson, MS 39204-4317 | 2013-12-08 |
| 1831347038 | Buckeye Community Services, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 W South St, Jackson, OH 45640-1504 | 2008-09-03 |
| 1760668198 | Residential Loving Care Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2924 Bryantown Road, 105 West Main Street, Ahoskie, Nc 27910, Jackson, NC 27845-0000 | 2008-01-16 |
| 1841312543 | Catholic Charities, Diocese of Metuchen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 384 Vath St, Jackson, NJ 08527-5216 | 2007-04-04 |
| 1316085558 | Christ Centered Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 327 W Monroe St, Jackson, MI 49202-2253 | 2007-02-01 |
| 1164569802 | Pdhcrc, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 205 17th St, Jackson, MI 49203-1403 | 2007-01-31 |
| 1184778805 | Twin Maples | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 158 Robinson Rd, Jackson, MI 49203-1053 | 2007-01-22 |
| 1497314017 | The Arc of Clarke County, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 501 Forest Ave, Jackson, AL 36545-3623 | 2019-06-07 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.