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Organization

GENESI LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROSANNE JILL NARDONI ISOM LLC (COUNSLER)
(405) 703-8755
Entity
Organization

Contact information

Practice address
9210 S WESTERN AVE, A-21, OKLAHOMA CITY, OK 73139-2734
(405) 703-8755
(405) 895-7544
Mailing address
9210 S WESTERN AVE, A-21, OKLAHOMA CITY, OK 73139-2734
(405) 703-8755
(405) 895-7544

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3512256863
OK

Other

Enumeration date
06/06/2011
Last updated
07/17/2014
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