Organization
GENESIS AT HOME LLC
Active
Organization
GENESIS AT HOME LLC
Active
Other names
Genesis At Home
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY AGHENTA (PRESIDENT)
(651) 246-7242
Entity
Organization
Contact information
Practice address
1027 W CALYPSO CT, GILBERT, AZ 85233-6769
(651) 246-7242
Mailing address
1027 W CALYPSO CT, GILBERT, AZ 85233-6769
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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