Organization
GENESIS HOUSE RECOVERY RESIDENCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ANTHONY DODGE (EXEUTIVE DIRECTOR)
(561) 439-4070
Entity
Organization
Contact information
Practice address
4865 40TH WAY S, LAKE WORTH, FL 33461-5301
(561) 439-4070
(561) 439-4864
Mailing address
4865 40TH WAY S, LAKE WORTH, FL 33461-5301
(561) 439-4070
(561) 439-4864
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
0950AD652501
FL
Other
Enumeration date
01/19/2007
Last updated
08/22/2020
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