Provider Demographics
NPI:1952284465
Name:LACAYO GENET LLC
Entity type:Organization
Organization Name:LACAYO GENET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GENET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-367-2725
Mailing Address - Street 1:114 ST MICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95425-3878
Mailing Address - Country:US
Mailing Address - Phone:707-367-2725
Mailing Address - Fax:866-583-0762
Practice Address - Street 1:611 CHERRY CREEK RD
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:CA
Practice Address - Zip Code:95425-3845
Practice Address - Country:US
Practice Address - Phone:707-669-5020
Practice Address - Fax:866-583-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)