Genesis Companion Services LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

GENESIS COMPANION SERVICES LLC

Practice address

6501 Arlington Expy Ste B105
Jacksonville, FL 32211-0810

Phone

(904) 675-0778

Fax

(904) 212-2591

NPI assigned

Mar 23, 2015

Organization subpart

No

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

Authorized official

Name

Tanisa Scippio

Title

Owner

Phone

(904) 405-5614

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1770977290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15865 LEXINGTON PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188148",
            "telephone_number": "904-405-5614",
            "fax_number": "904-212-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 ARLINGTON EXPY STE B105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322110810",
            "telephone_number": "904-675-0778",
            "fax_number": "904-212-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COMPANION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-23",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "SCIPPIO",
        "authorized_official_first_name": "TANISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-405-5614"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014096300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Genesis Clinical Counseling, LLC
• Genesis Health Development Inc
• Genesis Health Development, Inc.
• Genesis Health Development, Inc.
• Genesis Healthcare Corporation
• Genesis Home Care and Mental Health 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 Jan 13, 2023; 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.