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Organization

GENCARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GENEVA COLLINS (EXECUTIVE DIRECTOR/OWNER)
(540) 376-8723
Entity
Organization

Contact information

Practice address
5717 WOODBINE, FREDERICKSBURG, VA 22407-9211
(540) 693-4811
(540) 693-4091
Mailing address
5717 WOODBINE CT, FREDERICKSBURG, VA 22407-9211
(540) 693-4811
(540) 693-4091

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
04/17/2012
Last updated
10/18/2017
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