| NPI | 1346855848 |
|---|---|
| Doing Business As | GENESIS AT HOME |
| Entity Type | Organization |
| Authorized Contact | ANTHONY AGHENTA President 651-246-7242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-09-11 |