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Genesis Corporation
Intellectual Disabilities Intermediate Care Facility in San Lorenzo, California
NPI 1023004561

Genesis Corporation is a Intellectual Disabilities Intermediate Care Facility based in Pismo Beach, CA. Genesis Corporation practices in San Lorenzo, CA. The NPI Number for Genesis Corporation is 1023004561 and holds a License No. (California).

The current practice location address for Genesis Corporation is 17096 Via Flores, San Lorenzo, CA and can be reached out via phone at 510-276-8442 and via fax at 510-276-7802.

Location: 17096 Via Flores, San Lorenzo, CA, 93448-0626
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1023004561
Provider Name
Genesis Corporation
Credential
Provider Entity Type
Organization
Address
17096 Via Flores, San Lorenzo, CA, 93448-0626
Phone Number
510-276-8442
Fax Number
510-276-7802
Provider Enumeration Date
09/20/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC60739F 05 CA
institution
Provider Business Practice Location Address Details
Address
17096 Via Flores
City
San Lorenzo
State
California
Zip
94580-2915
Phone Number
510-276-8442
Fax Number
510-276-7802
person
Provider Business Mailing Address Details
Address
17096 Via Flores
City
San Lorenzo
State
California
Zip
94580-2915
Phone Number
510-276-8442
Fax Number
510-276-7802
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
(California)
Definition
(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.
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