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Organization
GENESIS HOUSE, INC
Active
Organization
GENESIS HOUSE, INC
Active
Parent organization
GENESIS HOUSE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS HOUSE, INC.
Authorized official
MS. SHAKEENA BERNIQUE LEE LSW, MSW, CAADC,ACSW (EXECUTIVE DIRECTOR)
(570) 322-0520
Entity
Organization
Contact information
Practice address
823 CENTRAL ROAD, BLOOMSBURG, PA 17815
(570) 322-0520
(570) 326-9674
Mailing address
800 WEST 4TH STREET, STE G-01, WILLIAMSPORT, PA 17701-7201
(570) 322-0520
(570) 326-9674
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261Q00000X
Clinic/Center
197052
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
Other
Enumeration date
05/16/2008
Last updated
10/27/2025
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