Organization
SECOND GENESIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SEGAL LCSW-C (DIRECTOR OF CLINICAL OPERATIONS)
(301) 563-1545
Entity
Organization
Contact information
Practice address
1320 HARVARD ST NW, WASHINGTON, DC 20009-4904
(202) 222-0120
Mailing address
1320 HARVARD ST NW, WASHINGTON, DC 20009-4904
(202) 222-0120
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
CRF-000125
DC
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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