# GENESIS

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

## Provider details

- **NPI number:** 1316231160
- **Authorized official:** MONIQUE PRICE (PROGRAM MANAGER)
- **Authorized official phone:** (410) 350-8514

## Contact information

- **Practice address:** 613 HAMMONDS LN, BROOKLYN PARK, MD 21225-3351
- **Practice address phone:** (410) 350-8514
- **Mailing address:** 613 HAMMONDS LN, BROOKLYN PARK, MD 21225-3351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 225200000X | MD | Yes |

## Other

- **Enumeration date:** 06/08/2011
- **Last updated:** 06/08/2011