Organization
JENESIS CONSULTING AND DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONIQUE CARTER (PRESIDENT)
(678) 464-8223
Entity
Organization
Contact information
Practice address
4274 BELAIR FRONTAGE RD STE 1, AUGUSTA, GA 30909-9428
(678) 464-8223
(706) 432-6290
Mailing address
4274 BELAIR FRONTAGE RD STE 1, AUGUSTA, GA 30909-9428
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049473917
DRIVERS LICENSE
GA
Enumeration date
11/07/2017
Last updated
11/07/2017
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