GENESIS ENTERPRISES INC (NPI# 1871631283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871631283 |
| Entity Type | Organization |
| Organization Name | GENESIS ENTERPRISES INC |
| Other Organization Name | GENESIS HOUSE |
| Practice Address |
350 Sycamore Rd Genoa IL 60135-1361 |
| Practice Telephone | 8157845146 |
| Practice Fax Number | 8157842594 |
| Mailing Telephone | 8157843712 |
| Mailing Fax Number | 8157844673 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. DESIREE ALICIA HENDERSON SAWYER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8157843712 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 0031906 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Genesis House | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316929599 | Genesis Enterprises Inc | Pharmacy | 1876 Craigshire Rd, Saint Louis, MO 63146-4006 | 2005-11-15 |
| Street Address |
350 SYCAMORE RD |
| City | GENOA |
| State | IL |
| Zip Code | 60135-1361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942686258 | Genesis Dtc, LLC | Day Training, Developmentally Disabled Services | 350 Sycamore Rd, Genoa, IL 60135-1361 | 2015-08-10 |
| 1487045761 | Avancer Homes, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 350 Sycamore Rd, Genoa, IL 60135-1361 | 2015-02-09 |
| 1154450773 | Avancer | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 350 Sycamore Rd, Genoa, IL 60135-1361 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697830 | Mayuri Prashant Shende | Student in an Organized Health Care Education/Training Program | 2160 S. First Ave., Bldg. 105, Suite 2840a, Marywood, IL 60135 | 2020-10-21 |
| 1831368612 | Northern Rehabilitation and Sports Medicine Associates | Physical Therapist | 540 E Main Street, Suite 5, Genoa, IL 60135 | 2008-02-26 |
| 1578582474 | Steven J Disanti | General Practice | 109 South Genoa Street, Genoa Medical Clinic, Genoa, IL 60135 | 2006-07-19 |
| 1558828947 | Victoria Elizabeth Deku | Speech-Language Pathologist | 123 W 1st St, Genoa, IL 60135-1016 | 2019-02-22 |
| 1134321698 | Genoa Kingston Cusd 424 | Local Education Agency (LEA) | 941 W Main St, Genoa, IL 60135-1037 | 2007-06-05 |
| 1992256309 | Angela Moore | Nurse's Aide | 519 W 2nd St, Genoa, IL 60135-1058 | 2016-10-20 |
| 1609887918 | Martha Ann Moegling | Chiropractor | 112 N Emmett St Ste A, Genoa, IL 60135-1087 | 2006-08-11 |
| 1306858154 | Natural Family Health S.c. | Chiropractor | 112 N Emmett St Ste A, Genoa, IL 60135-1087 | 2006-08-12 |
| 1013939602 | Steven J. Disanti D.o. S.c. | Family Medicine | 109 S Genoa St, Genoa, IL 60135-1120 | 2006-07-24 |
| 1659511632 | Sherie Anne Perdue | Dentist | 209 W Main St, Genoa, IL 60135-1145 | 2009-03-03 |
| Find all providers in zip 60135 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871039669 | Mount St Joseph | Intermediate Care Facility, Mentally Retarded | 24955 N Us Highway 12, Lake Zurich, IL 60047-8919 | 2017-01-17 |
| 1447792221 | Shore Community Services, Inc. | Intermediate Care Facility, Mentally Retarded | 8350 Laramie Ave, Skokie, IL 60077-2461 | 2016-11-10 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
| 1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
| 1376909374 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 416 Chula Vista Dr, Belleville, IL 62221-3160 | 2016-01-06 |
| 1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
| 1790141885 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 212 Turning Leaf Cir, Belleville, IL 62221-6747 | 2016-01-06 |
| 1790141794 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 867 County Road 2150 E, Fairfield, IL 62837-2824 | 2016-01-06 |
| 1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GENESIS ENTERPRISES INC.
| 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.