Organization
GENESIS ENTERPRISES INC
Active
Other names
Genesis House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESIREE ALICIA HENDERSON SAWYER (EXECUTIVE DIRECTOR)
(815) 784-3712
Entity
Organization
Contact information
Practice address
350 SYCAMORE RD, GENOA, IL 60135-1361
(815) 784-5146
(815) 784-2594
Mailing address
350 SYCAMORE RD, GENOA, IL 60135-1361
(815) 784-3712
(815) 784-4673
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0031906
IL
Other
Enumeration date
02/01/2007
Last updated
08/22/2020
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