Organization
GENESIS GRACE HOME INC
Active
Other names
Genesis Grace Home INC, Genesis Grace Home
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN AWUNDAGA (OWNER)
(164) 673-0024
Entity
Organization
Contact information
Practice address
442 SOUTH BROADWAY, CAMDEN, NJ 08103-1246
(646) 730-0249
Mailing address
442 SOUTH BROADWAY, CAMDEN, NJ 08103-1246
(646) 730-0249
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
11/20/2020
Last updated
04/17/2026
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