# GENESIS SUBSTANCE ABUSE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GENESIS FAMILY CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952518649
- **Authorized official:** MISS TONGIA SULLIVAN BA, SWK (PROGRAM COORDINATOR)
- **Authorized official phone:** (559) 439-5437

## Contact information

- **Practice address:** 7475 N PALM AVE STE 107, FRESNO, CA 93711-5763
- **Practice address phone:** (559) 439-5437
- **Practice address fax:** (559) 439-5411
- **Mailing address:** 7475 N PALM AVE STE 107, FRESNO, CA 93711-5763
- **Mailing address phone:** (559) 439-5437
- **Mailing address fax:** (559) 439-5411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0800X | Recovery Care Clinic/Center | 100043AN | CA | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 08/22/2007