NPIMap

Organization Active NPI

Genesis Developmental Disability Center LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Omaha, NE
National Provider Identifier
1639908213
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
GENESIS DEVELOPMENTAL DISABILITY CENTER LLC
Practice address
4611 S 96TH St Ste 115
Omaha, NE 68127-1227
Phone
(402) 378-6972
NPI assigned
Jul 31, 2024
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Abdullahi O FarahNPI 1073400784
Title
Ceo
Phone
(402) 378-6972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Home Health Agency 251E00000X NU
Developmental Disabilities Clinic/Center 261QD1600X NU
Mental Illness Community Based Residential Treatment Facility 320800000X NU
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary
Non-emergency Medical Transport (VAN) 343900000X NU
Respite Care 385H00000X NU
Foster Care Agency 253J00000X NU
In Home Supportive Care Agency 253Z00000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

4611 S 96TH St Ste 115
Omaha, NE 68127-1227

Mailing address

4611 S 96TH St Ste 115
Omaha, NE 68127-1227

National Provider Directory

National Provider Directory

Locations

4611 S 96th St
Ste 115
Omaha, NE 68127
Phone (402) 378-6972

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1639908213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 115",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 115",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271227",
            "telephone_number": "402-378-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DEVELOPMENTAL DISABILITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "ABDULLAHI",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-378-6972"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.