Genesis Home Care and Mental Health Services

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

GENESIS HOME CARE AND MENTAL HEALTH SERVICES

Practice address

8750 Humberside LN
Jacksonville, FL 32219-4317

Phone

(904) 713-1993

NPI assigned

Jul 29, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steven Byrd

Title

Owner

Phone

(904) 713-1993

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1043829682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47164",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322477164",
            "telephone_number": "904-713-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 HUMBERSIDE LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322194317",
            "telephone_number": "904-713-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOME CARE AND MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-713-1993",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102625400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Companion Services LLC
• Genesis Health Development Inc
• Genesis Health Development, Inc.
• Genesis Health Development, Inc.
• Genesis Healthcare Corporation
• Genesis Home Healthcare, Limited Liability Company, Jackso
• Genesis Rehabilitation Hospital, Inc.
• Genesis Rehabilitation Hospital, Inc.
• Genesis Rehabilitation Hospital, Inc.
• Genesis Support Services

• All providers in Jacksonville, FL
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.