Genesis Assisted Living Facility, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

11025 Issued in FL

Legal business name

GENESIS ASSISTED LIVING FACILITY, INC

Practice address

1510 SW 68 Ave
North Lauderdale, FL 33068

Phone

(954) 971-0246

NPI assigned

Jan 19, 2011

Organization subpart

No

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

Authorized official

Name

Priscilla Mowatt

Title

Owner/Administrator

Phone

(954) 971-0246

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1487959615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SW 68 AVE",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "33068",
            "telephone_number": "954-971-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 SW 68 AVE",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "33068",
            "telephone_number": "954-971-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ASSISTED LIVING FACILITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "MOWATT",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "954-971-0246"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "11025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in North Lauderdale, FL
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• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.