# GENESIS WELLNESS SUPPORT CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235993155
- **Authorized official:** YISCEL MARIA M PASCUAL BERMUDEZ CBHCMS (OWNER)
- **Authorized official phone:** (786) 207-1151

## Contact information

- **Practice address:** 10700 CARIBBEAN BLVD STE 214, CUTLER BAY, FL 33189-1233
- **Practice address phone:** (786) 207-1151
- **Practice address fax:** (786) 221-2834
- **Mailing address:** 9333 SW 227TH ST UNIT 1, CUTLER BAY, FL 33190-1947
- **Mailing address phone:** (786) 740-0516
- **Mailing address fax:** (786) 221-2834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 02/12/2024
- **Last updated:** 07/23/2026