Organization
GENESIS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF BOTT (EXECUTIVE DIRECTOR)
(206) 860-2621
Entity
Organization
Contact information
Practice address
621 34TH AVE, SEATTLE, WA 98122-0910
(206) 860-2621
(206) 323-5247
Mailing address
PO BOX 22910, SEATTLE, WA 98122-0910
(206) 860-2621
(206) 323-5247
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992023
SUBSTANCE ABUSE
WA
Enumeration date
05/04/2007
Last updated
08/22/2020
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