Provider Demographics
NPI:1336381417
Name:GENESIS WORLD EVANGELISM INC
Entity Type:Organization
Organization Name:GENESIS WORLD EVANGELISM INC
Other - Org Name:GENESIS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-293-3620
Mailing Address - Street 1:4627 LAKE IN THE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607-2319
Mailing Address - Country:US
Mailing Address - Phone:352-293-3620
Mailing Address - Fax:
Practice Address - Street 1:7237 DAVENPORT LN
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-6348
Practice Address - Country:US
Practice Address - Phone:352-293-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility