Genesis Manor, LLC

NPI #1972875318 in Lynchburg, Virginia

Provider Information

NPI Number: 1972875318
Entity Type: Organization
Organization Name: Genesis Manor, LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 1, 2012
Last Updated: Feb 1, 2012

Practice Location

Address: 1560 KNOTT ST
City: Lynchburg
State: Virginia
ZIP Code: 24502-5107
Phone: (434) 237-2044

Authorized Official

Name: MS. CHRISTINA SMITH JACKSON
Title: RECORDS MANAGER/COOWNER
Phone: (434) 610-6132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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