Genesis Club, Inc. | |
274 Lincoln St Worcester MA 01605-2106 | |
(508) 831-0100 | |
(508) 753-1286 |
Full Name | Genesis Club, Inc. |
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Speciality | Community/behavioral Health |
Location | 274 Lincoln St, Worcester, Massachusetts |
Authorized Official Name and Position | Kevin L Bradley (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5088310100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Genesis Club, Inc. 274 Lincoln St Worcester MA 01605-2106 Ph: (508) 831-0100 | Genesis Club, Inc. 274 Lincoln St Worcester MA 01605-2106 Ph: (508) 831-0100 |
NPI Number | 1568871663 |
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Provider Enumeration Date | 08/04/2014 |
Last Update Date | 06/20/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568871663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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