GENESIS DEVELOPMENTAL SERVICES
NPI 1023004561
Intermediate Care Facility, Intellectual Disabilities in San Lorenzo, CA

NPI Status: Active since September 20, 2005

Contact Information

17096 VIA FLORES
SAN LORENZO, CA
ZIP 94580
Phone: (510) 276-8442
Fax: (510) 276-7802

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About GENESIS DEVELOPMENTAL SERVICES

This page provides the complete NPI Profile along with additional information for Genesis Developmental Services, a provider established in San Lorenzo, California operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1023004561 assigned on September 2005. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Genesis Developmental Services. The authorized official of this NPI record is Ms. Pamela Graham (Controller)

NPI
1023004561
Provider Legal Name
GENESIS CORPORATION
Other Organization Name
GENESIS DEVELOPMENTAL SERVICES
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
17096 VIA FLORES SAN LORENZO, CA 94580
Location Phone
(510) 276-8442
Location Fax
(510) 276-7802
Mailing Address
PO BOX 626 PISMO BEACH, CA 93448
Mailing Phone
(805) 489-9472
Mailing Fax
(510) 276-7802
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-20-2005
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
License State
CA
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. PAMELA GRAHAM

Authorized Official Title
CONTROLLER
Authorized Official Phone
(805) 489-9472

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
LTC60739FMEDICAID (05)CA 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1023004561
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2043008512
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 4 + 3 + 0 + 0 + 8 + 5 + 1 + 2 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1023004561 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023004561, enumerated in the NPI registry as an "organization" on September 20, 2005

The provider is located at 17096 Via Flores San Lorenzo, Ca 94580 and the phone number is (510) 276-8442

This medical organization specializes in Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on September 20, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.