GENESIS HOME CARE AND MENTAL HEALTH SERVICES (NPI# 1043829682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043829682 |
| Entity Type | Organization |
| Organization Name | GENESIS HOME CARE AND MENTAL HEALTH SERVICES |
| Practice Address |
8750 Humberside Ln Jacksonville FL 32219-4317 |
| Mailing Address |
Po Box 47164 Jacksonville FL 32247-7164 |
| Practice Telephone | 9047131993 |
| Mailing Telephone | 9047131993 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | MR. STEVEN BYRD (OWNER) |
| Authorized Official Telephone | 9047131993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 372600000X | Adult Companion | Nursing Service Related Providers | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 102625400 | 05 |
| Street Address |
8750 HUMBERSIDE LN |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32219-4317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902182447 | Beatrice E Hall | Technician | 5838 Soutel Dr., Jacksonville, FL 32219 | 2011-10-28 |
| 1437173697 | Bennie Clark Jr. | Dentist | 5475 Soutel Drive, Jacksonville, FL 32219 | 2006-07-27 |
| 1801842679 | Susan E. Kurner | Counselor | 10149 Fox Lake Ct, Jacksonville, FL 32219-1693 | 2006-05-25 |
| 1841629243 | Latonia Delores Simmons | Day Training, Developmentally Disabled Services | 12428 Cadley Cir, Jacksonville, FL 32219-1861 | 2013-11-06 |
| 1114495512 | La Assistant Services | Home Health Aide | 12428 Cadley Cir, Jacksonville, FL 32219-1861 | 2018-11-05 |
| 1831759141 | Stephanie R Forde | Technician | 12379 Glimmer Way, Jacksonville, FL 32219-1867 | 2019-06-18 |
| 1700372869 | Valerie M Vinson-anderson | In Home Supportive Care | 6751 Langford St, Jacksonville, FL 32219-1875 | 2018-07-02 |
| 1821528860 | Samaiyah Harris | Adult Companion | 6967 Sandle Dr, Jacksonville, FL 32219-1884 | 2017-06-13 |
| 1023508595 | Present Help Companion Services, LLC | Respite Care | 6967 Sandle Dr, Jacksonville, FL 32219-1884 | 2018-05-10 |
| 1629635420 | Kimberly Walker | Registered Nurse | 8921 Merseyside Ave, Jacksonville, FL 32219-2374 | 2019-05-28 |
| Find all providers in zip 32219 | ||||
| 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 |
|---|---|---|---|---|
| 1245847268 | Joshua R Grant | Day Training, Developmentally Disabled Services | 2405 Almeda St, Jacksonville, FL 32209-4632 | 2020-09-24 |
| 1760092589 | I Am Care LLC | Day Training, Developmentally Disabled Services | 6732 Gentle Oaks Dr, Jacksonville, FL 32244-3690 | 2020-08-06 |
| 1780200386 | Exceptional Comfort and Care, LLC | Day Training, Developmentally Disabled Services | 9608 Woodstone Mill Dr, Jacksonville, FL 32244-7911 | 2020-06-19 |
| 1902427370 | Endless Possibilities of Hope LLC | Day Training, Developmentally Disabled Services | 3410 Kingston St, Jacksonville, FL 32254-2338 | 2020-04-27 |
| 1144850835 | Safekeeping Support Services, LLC | Day Training, Developmentally Disabled Services | 10316 Red Tip Rd, Jacksonville, FL 32218-9132 | 2020-01-22 |
| 1174153852 | Erica C Williams | Day Training, Developmentally Disabled Services | 1026 Gallant Fox Cir S, Jacksonville, FL 32218-1955 | 2020-01-22 |
| 1336602093 | Special Methods In Life Enrichment Services LLC | Day Training, Developmentally Disabled Services | 7187 Overland Park Blvd E, Jacksonville, FL 32244-4254 | 2019-04-10 |
| 1013481720 | Dorothy Washington | Day Training, Developmentally Disabled Services | 6316 San Juan Ave Ste 41a, Jacksonville, FL 32210-2883 | 2019-01-15 |
| 1114492295 | Xiaxiang Daniels | Day Training, Developmentally Disabled Services | 5620 Collins Rd Apt 109, Jacksonville, FL 32244-6909 | 2018-10-04 |
| 1134613540 | Sunshine Support Services, LLC | Day Training, Developmentally Disabled Services | 9205 Redtail Dr, Jacksonville, FL 32222-2811 | 2018-06-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32219 |
Please comment or provide details below to improve the information on GENESIS HOME CARE AND MENTAL HEALTH SERVICES.
| 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.