Organization
GENESIS FAMILY FOUNDATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENS DANIEL DE KONING CPRC (CHIEF EXECUTIVE OFFICER)
(346) 208-4147
Entity
Organization
Contact information
Practice address
1110 NASA PKWY STE 201, HOUSTON, TX 77058-3359
(713) 913-4575
Mailing address
1110 NASA PKWY STE 201, HOUSTON, TX 77058-3359
(713) 913-4575
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063113645
NPI OF PROVIDER AT OUR ORGANIZATION
TX
Enumeration date
03/24/2023
Last updated
03/24/2023
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