| Genoa Services Llc | |
|
222 Indianapolis Blvd Ste 207 Schererville IN 46375-1275 | |
| (219) 808-0793 | |
| (219) 756-0795 |
| Full Name | Genoa Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 222 Indianapolis Blvd Ste 207, Schererville, Indiana |
| Authorized Official Name and Position | Emily D Edwards (OWNER, SINGLE MEMBER) |
| Authorized Official Contact | 2198080793 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genoa Services Llc 222 Indianapolis Blvd Ste 207 Schererville IN 46375-1275 Ph: (219) 808-0793 | Genoa Services Llc 222 Indianapolis Blvd Ste 207 Schererville IN 46375-1275 Ph: (219) 808-0793 |
| NPI Number | 1255454120 |
|---|---|
| Provider Enumeration Date | 04/07/2007 |
| Last Update Date | 02/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255454120 | NPI | - | NPPES |
| 100475220C | Medicaid | IN | |
| 200240460A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 99025162A (Indiana) | Primary |
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