# GENESIS

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

## Provider details

- **NPI number:** 1801211701
- **Authorized official:** REBEKAH DARLENE BROWN (COTA)
- **Authorized official phone:** (304) 237-6771

## Contact information

- **Practice address:** 934 S FAYETTE ST, BECKLEY, WV 25801-6549
- **Practice address phone:** (304) 237-6771
- **Mailing address:** 934 S FAYETTE ST, BECKLEY, WV 25801-6549
- **Mailing address phone:** (304) 237-6771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | C1733 | WV | Yes |

## Other

- **Enumeration date:** 02/28/2014
- **Last updated:** 02/28/2014
