Organization
GENESIS II, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GOLD (EXECUTIVE DIRECTOR)
(215) 978-5191
Entity
Organization
Contact information
Practice address
1239 SPRING GARDEN ST, SUITE 300, PHILADELPHIA, PA 19123-3206
(215) 978-5191
(215) 978-8017
Mailing address
1239 SPRING GARDEN ST, SUITE 300, PHILADELPHIA, PA 19123-3206
(215) 978-5191
(215) 978-8017
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
807289
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008220780001
—
PA
Enumeration date
02/13/2007
Last updated
08/22/2020
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