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Organization

GENESIS ASSISTED LIVING L.L.C.

Active
Other names
Genesis Assisted Living
Organization subpart
No

Provider details

NPI number
Authorized official
DJOUDLIN GERMINAL (ADMINISTRATOR)
(941) 545-6797
Entity
Organization

Contact information

Practice address
14138 CRUTCHFIELD CT FL 34219, PARRISH, FL 34219-9408
(813) 270-4583
Mailing address
5352 ROCKY COAST PL, PALMETTO, FL 34221-1423
(941) 545-6797

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
3104A0625X
Assisted Living Facility (Mental Illness)
3104A0630X
Assisted Living Facility (Behavioral Disturbances)

Other

Enumeration date
08/26/2025
Last updated
08/26/2025
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