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Jody Lyn Genuard, NC10062045
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Lakewood, Washington
NPI 1790038420

Jody Lyn Genuard is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Lakewood, WA. Jody Lyn Genuard practices in Lakewood, WA and has the professional credentials of NC10062045. The NPI Number for Jody Lyn Genuard is 1790038420 and holds a License No. NC 10062045 (Washington).

The current practice location address for Jody Lyn Genuard is 9330 59Th Ave Sw, Lakewood, WA and can be reached out via phone at 253-298-9141.

Location: 9330 59Th Ave Sw, Lakewood, WA, 98499
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790038420
Provider Name
Jody Lyn Genuard
Credential
NC10062045
Provider Entity Type
Individual
Gender
Female
Address
9330 59Th Ave Sw, Lakewood, WA, 98499
Phone Number
253-298-9141
Fax Number
Provider Enumeration Date
10/18/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9330 59Th Ave Sw
City
Lakewood
State
Washington
Zip
98499-2858
Phone Number
253-298-9141
Fax Number
person
Provider Business Mailing Address Details
Address
9330 59Th Ave Sw
City
Lakewood
State
Washington
Zip
98499-2858
Phone Number
253-298-9141
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
NC 10062045 (Washington)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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