NPIMap

Organization Active NPI

Genesis Living

  • Mental Illness Community Based Residential Treatment Facility
  • Gilbert, AZ
National Provider Identifier
1851872832
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
GENESIS LIVING
Practice address
2839 E Courtney St
Gilbert, AZ 85298-5735
Phone
(651) 955-6535
NPI assigned
Aug 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Rita AghentaNPI 1245620665
Title
Administrator
Phone
(651) 955-6535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X BH5499 AZ
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

2839 E Courtney St
Gilbert, AZ 85298-5735

Mailing address

2839 E Courtney St
Gilbert, AZ 85298-5735
Phone (651) 955-6535

Other practice location 1

41804 W Carlisle Ln
Maricopa, AZ 85138-3263
Phone (651) 955-6535

National Provider Directory

National Provider Directory
Tax ID family
Genesis Living2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1851872832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2839 E COURTNEY ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852985735",
            "telephone_number": "651-955-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2839 E COURTNEY ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852985735",
            "telephone_number": "651-955-6535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41804 W Carlisle Ln",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851383263",
            "country_code": "US",
            "telephone_number": "651-955-6535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENESIS LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "AGHENTA",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-955-6535"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "AZ",
            "license": "BH5499",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.