MEDICARE: GENESIS HEALTH DEVELOPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063681831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS HEALTH DEVELOPMENT, INC.

Provider Business Mailing Address
First Line	:	3599 UNIVERSITY BLVD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4252
Country	:	US
Telephone Number	:	904-345-7291
Fax Number	:	904-345-7284

Provider Business Practice Location Address
First Line	:	2700 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2147
Country	:	US
Telephone Number	:	904-674-6400
Fax Number	:	904-345-7284

Authorized Official
Title or Position	:	DIRECTOR OF MANAGEDCARE
Name	:	JENI ALLEN
Credential	:
Telephone Number	:	904-345-7158

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	12/23/2025

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