GENESIS DTC, LLC (NPI# 1942686258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942686258 |
| Entity Type | Organization |
| Organization Name | GENESIS DTC, LLC |
| Practice Address |
350 Sycamore Rd Genoa IL 60135-1361 |
| Practice Telephone | 8157845146 |
| Practice Fax Number | 8157844673 |
| Mailing Telephone | 8157845146 |
| Mailing Fax Number | 8157844673 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |
| Authorized Official Name | DESIREE A JOHNSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8157845146 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GENESIS DTC, LLC | 350 Sycamore Rd, Genoa, IL 60135-1361 |
| Street Address |
350 SYCAMORE RD |
| City | GENOA |
| State | IL |
| Zip Code | 60135-1361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871631283 | Genesis Enterprises Inc | Intermediate Care Facility, Mentally Retarded | 350 Sycamore Rd, Genoa, IL 60135-1361 | 2007-02-01 |
| 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 | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515665 | People Overcoming With Everlasting Results, Inc. | Day Training, Developmentally Disabled Services | 6400 W Main St Ste 1f-3, Belleville, IL 62223-3806 | 2019-12-19 |
| 1386132520 | It Takes A Community LLC | Day Training, Developmentally Disabled Services | 9046 S Justine St, Chicago, IL 60620 | 2018-04-24 |
| 1215424460 | Victor C. Neumann Association | Day Training, Developmentally Disabled Services | 4434 W Diversey Ave, Chicago, IL 60639-1939 | 2018-04-13 |
| 1194212399 | Victor C Neumann Association | Day Training, Developmentally Disabled Services | 4122 N Nashville Ave, Chicago, IL 60634-1429 | 2018-04-13 |
| 1952825770 | Help At Home, LLC | Day Training, Developmentally Disabled Services | 1 N State St Ste 800, Chicago, IL 60602-3312 | 2017-08-02 |
| 1316478878 | Kathryn Elaine Miller Rose | Day Training, Developmentally Disabled Services | 1207 Lakeside Ln, Mahomet, IL 61853-9767 | 2017-03-25 |
| 1063943645 | Lf Walls Corp | Day Training, Developmentally Disabled Services | 1404 Fox Hound Trl, Beecher, IL 60401-5106 | 2017-03-24 |
| 1285186254 | Dorr-wood Ltd | Day Training, Developmentally Disabled Services | 1001 Rail Dr, Woodstock, IL 60098-9411 | 2016-10-26 |
| 1558818930 | Autismchicago | Day Training, Developmentally Disabled Services | 8035 S Wabash Ave, Chicago, IL 60619-3516 | 2016-09-02 |
| 1518411594 | Transitions of Western Illinois | Day Training, Developmentally Disabled Services | 631 N 48th St, Quincy, IL 62305-7918 | 2016-08-08 |
| Find all providers with the same taxonomy | ||||
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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.