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Organization

GENESIS REHABILITATION CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEORGE MORENO CADC II, CCDS (PROGRAM DIRECTOR)
(213) 739-9982
Entity
Organization

Contact information

Practice address
3440 WILSHIRE BLVD STE 909, LOS ANGELES, CA 90010-2101
(213) 739-9982
(213) 739-9983
Mailing address
3440 WILSHIRE BLVD STE 909, LOS ANGELES, CA 90010-2101
(213) 739-9982
(213) 739-9983

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
190039AP
CA
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
01/22/2018
Last updated
10/10/2018
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