Organization
GENESIS COMMUNITY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENESIS ABREU ETTIENNE (PRESIDENT)
(305) 318-7391
Entity
Organization
Contact information
Practice address
2720 NW 167TH ST, MIAMI GARDENS, FL 33054-6400
(305) 318-7391
Mailing address
2720 NW 167TH ST, MIAMI GARDENS, FL 33054-6400
(305) 318-7391
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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