| Genesis House | |
|
1149 Warren Ave Vallejo CA 94591-7512 | |
| (707) 552-5295 | |
| Not Available |
| Full Name | Genesis House |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1149 Warren Ave, Vallejo, California |
| Authorized Official Name and Position | Kester Mcdonald (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7075525295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis House 1149 Warren Ave Vallejo CA 94591-7512 Ph: (707) 552-5295 | Genesis House 1149 Warren Ave Vallejo CA 94591-7512 Ph: (707) 552-5295 |
| NPI Number | 1841954856 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 11/01/2021 |
| Certification Date | 11/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841954856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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