| Organization Name: | GENOA SERVICES LLC |
| NPI Number: | 1255454120 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMILY D EDWARDS (OWNER, SINGLE MEMBER) |
| Mailing Address: | 222 Indianapolis Blvd Ste 207 Schererville |
| State: | IN US |
| Postal Code: | 463751275 |
| Phone Number: | 2198080793 |
| Fax Number: | 2197560795 |
| NPI Enumeration Date: | 04/07/2007 |
| NPI Last Update Date: | 02/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 99025162A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |