Organization
GENESIS FAMILY CENTER
Active
Parent organization
GENESIS SUBSTANCE ABUSE SERVICES
Other names
GENESIS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS SUBSTANCE ABUSE SERVICES
Authorized official
MISS TONGIA SULLIVAN BA SOCIAL WORK (PROGRAM COORDINATOR)
(559) 439-5437
Entity
Organization
Contact information
Practice address
1260 N MARIPOSA ST, FRESNO, CA 93703-3940
(559) 233-3246
Mailing address
1260 N MARIPOSA, FRESN0, CA 93703
(559) 233-3246
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100043AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
MEDI-CAL
CA
Enumeration date
01/02/2008
Last updated
01/02/2008
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