| Genesis Family Support Services, Inc. | |
|
223 E Magnolia Ave Louisville KY 40208-2025 | |
| (502) 224-7067 | |
| Not Available |
| Full Name | Genesis Family Support Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 223 E Magnolia Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Donna Burks (PRESIDENT/CEO) |
| Authorized Official Contact | 5022247067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Family Support Services, Inc. Po Box 3183 Louisville KY 40201-3183 Ph: (502) 224-7067 | Genesis Family Support Services, Inc. 223 E Magnolia Ave Louisville KY 40208-2025 Ph: (502) 224-7067 |
| NPI Number | 1619158847 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 11/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619158847 | NPI | - | NPPES |
| 29100054 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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