Genesis Cila Homes Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

201500005C Issued in IL

Legal business name

GENESIS CILA HOMES INC

Practice address

441 S Dante Ave
Glenwood, IL 60425-2045

Phone

(708) 915-0920

Fax

(708) 758-0695

NPI assigned

Oct 20, 2016

Organization subpart

No

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

Authorized official

Name

Philomena OdiaseNPI 1790161701

Title

Ceo

Phone

(708) 915-0920

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philomena Odiase

  • Community/Behavioral Health Agency
  • Glenwood, IL
  • NPI 1790161701
  NPD (past) Authorized official

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1780135194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 S DANTE AVE",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604252045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 S DANTE AVE",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604252045",
            "telephone_number": "708-915-0920",
            "fax_number": "708-758-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CILA HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "ODIASE",
        "authorized_official_first_name": "PHILOMENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-915-0920"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "201500005C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dancy Enterprise
• Margaret Alexis Dandridge
• Daniel E. Hermanson, OD, LTD.
• Bridget Duggan, CCC/SLP
• Guameda Eady, APN
• Glenwood Healthcare & Rehab, Inc
• Glenwood Healthcare and Rehab
• Kenyetta Hall
• Denetra L Hardy, LPC
• Arteasia Harris, CNA

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Glenwood, IL
• Providers in Glenwood, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.