Organization
GENESIS COMPANION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANISA SCIPPIO (OWNER)
(904) 405-5614
Entity
Organization
Contact information
Practice address
6501 ARLINGTON EXPY STE B105, JACKSONVILLE, FL 32211-0810
(904) 675-0778
(904) 212-2591
Mailing address
15865 LEXINGTON PARK BLVD, JACKSONVILLE, FL 32218-8148
(904) 405-5614
(904) 212-2591
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
FL
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014096300
—
FL
Enumeration date
03/23/2015
Last updated
01/13/2023
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