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Organization
GENESIS3 LLC
Active
Organization
GENESIS3 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARRANCE HAYES (CEO)
(757) 660-5786
Entity
Organization
Contact information
Practice address
911 JAMES DR, NEWPORT NEWS, VA 23605-1929
(757) 660-5786
Mailing address
911 JAMES DR, NEWPORT NEWS, VA 23605-1929
(757) 660-5786
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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