# GENESIS HOMES OF JACKSON INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225366313
- **Authorized official:** MS. SHELLY S KEINATH (PRESIDENT)
- **Authorized official phone:** (517) 782-3280

## Contact information

- **Practice address:** 6853 HAGUE AVE, JACKSON, MI 49201-8334
- **Practice address phone:** (517) 782-3280
- **Mailing address:** 6853 HAGUE AVE, JACKSON, MI 49201-8334
- **Mailing address phone:** (517) 782-3280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | AF380246001 | MI | Yes |

## Other

- **Enumeration date:** 11/30/2009
- **Last updated:** 11/30/2009