Organization
GENESIS LIVING
Active
Parent organization
GENESIS LIVING
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS LIVING
Authorized official
RITA AGHENTA (ADMINISTRATOR)
(651) 955-6535
Entity
Organization
Contact information
Practice address
41804 W CARLISLE LN, MARICOPA, AZ 85138-3263
(651) 955-6535
Mailing address
1027 W CALYPSO CT, GILBERT, AZ 85233-6769
(651) 955-6535
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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