Organization
GENESIS SPECIALTY GROUPS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA MEKDESSIE STUART (OWNER)
(225) 771-9980
Entity
Organization
Contact information
Practice address
778 CHEVELLE DRIVE, BATON ROUGE, LA 70806
(225) 771-8890
(225) 612-6920
Mailing address
PO BOX 83581, BATON ROUGE, LA 70884
(225) 771-9980
(225) 612-6420
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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