Genesis Healthcare Center LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GENESIS HEALTHCARE CENTER LLC

Practice address

25466 N Highway 5
Lebanon, MO 65536-6294

Phone

(417) 830-4420

NPI assigned

Jan 17, 2025

Last updated

Jan 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joshua Williams

Title

Authorized Person

Phone

(573) 795-5012

Specialties & licenses 1

Addresses

Tax ID family

Genesis Healthcare Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Genesis Healthcare Center LLC

  • In Home Supportive Care Agency
  • Lebanon, MO
  • NPI 1831904564
  NPD tax ID

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1366253387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 836",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634010836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25466 N HIGHWAY 5",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655366294",
            "telephone_number": "417-830-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "AUTHORIZED PERSON",
        "authorized_official_telephone_number": "573-795-5012"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi C Fox
• Martha J Frazier, MA
• Houston Freeman
• Evan E. Fusco, MD
• Daniel Garrison
• Genesis Healthcare Center LLC
• Philip V Giblin, MSW, LCSW
• Ronald D. Glas, MD
• Amanda Carol Glendenning, PT
• Christina Goans, PHARMD

• Assisted Living Facility in Lebanon, MO
• Providers in Lebanon, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.