| Genesis Family Development Services | |
|
192 Safe Haven Dr Clarksburg WV 26301-9103 | |
| (304) 622-1907 | |
| (304) 623-9346 |
| Full Name | Genesis Family Development Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 192 Safe Haven Dr, Clarksburg, West Virginia |
| Authorized Official Name and Position | Matt Rudder (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3046221907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Family Development Services Po Box 546 Clarksburg WV 26302-0546 Ph: (304) 622-1907 | Genesis Family Development Services 192 Safe Haven Dr Clarksburg WV 26301-9103 Ph: (304) 622-1907 |
| NPI Number | 1033585542 |
|---|---|
| Provider Enumeration Date | 08/19/2015 |
| Last Update Date | 08/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033585542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 13GR20 (West Virginia) | Primary |
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