GENESIS DTC, LLC
NPI 1942686258
Day Training, Developmentally Disabled Services in Genoa, IL

Active since August 10, 2015
350 SYCAMORE RD, GENOA, IL 60135(815) 784-5146(815) 784-4673 Get Directions Write a Review

NPPES record last updated: August 10, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Day Training, Developmentally Disabled S...

About GENESIS DTC, LLC

This page provides the complete NPI Profile along with additional information for Genesis Dtc, Llc, a provider established in Genoa, Illinois operating as a Day Training, Developmentally Disabled Services. The healthcare provider is registered in the NPI registry with number 1942686258 assigned on August 2015. The practitioner's primary taxonomy code is 251C00000X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Desiree A Johnson (Executive Director)

NPI
1942686258 Verify this NPI
Provider Name
GENESIS DTC, LLC
Entity Type
Organization
Location Address
350 SYCAMORE RD GENOA, IL 60135
Location Phone
(815) 784-5146
Location Fax
(815) 784-4673
Mailing Address
350 SYCAMORE RD GENOA, IL 60135
Mailing Phone
(815) 784-5146
Mailing Fax
(815) 784-4673
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-10-2015
Last Update Date
08-10-2015
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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

Day Training, Developmentally Disabled Services

Taxonomy Code
251C00000X
Type
Agencies
Taxonomy Description
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.

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

DESIREE A JOHNSON

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(815) 784-5146

Reviews for GENESIS DTC, LLC

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
350 SYCAMORE RD
GENOA, IL 60135
Intermediate Care Facility, Intellectual Disabilities
350 SYCAMORE RD
GENOA, IL 60135
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
350 SYCAMORE RD
GENOA, IL 60135

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1942686258, enumerated as an "organization" on August 10, 2015.

The provider is located at 350 SYCAMORE RD GENOA, IL 60135 and the phone number is (815) 784-5146.

Day Training, Developmentally Disabled Services with taxonomy code 251C00000X.