Organization
SECOND GENESIS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J MICHAEL MCGUINNESS MSW (EXECUTIVE DIRECTOR)
(301) 563-1545
Entity
Organization
Contact information
Practice address
4620 MELWOOD RD, UPPER MARLBORO, MD 20772-9507
(301) 563-1545
(301) 563-1546
Mailing address
8611 2ND AVE, SILVER SPRING, MD 20910-3372
(301) 563-1545
(301) 563-1546
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
903298
MD
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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