Organization
GENESIS HOUSE, INC
Active
Parent organization
GENESIS HOUSE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS HOUSE, INC.
Authorized official
MS. SHAKEENA BERNIQUE LEE LSW, MSW, CAADC,ACSW (EXECUTIVE DIRECTOR)
(570) 322-0520
Entity
Organization
Contact information
Practice address
823 CENTRAL ROAD, BLOOMSBURG, PA 17815
(570) 322-0520
(570) 326-9674
Mailing address
800 WEST 4TH STREET, STE G-01, WILLIAMSPORT, PA 17701-7201
(570) 322-0520
(570) 326-9674
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
197052
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007283800
—
PA
05
—
10072838000027
—
PA
Enumeration date
05/16/2008
Last updated
10/27/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us