Organization
GENESIS HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KESTER VORETT MCDONALD (EXECUTIVE DIRECTOR)
(707) 552-5295
Entity
Organization
Contact information
Practice address
1149 WARREN AVE, VALLEJO, CA 94591-7512
(707) 552-5295
(707) 552-3394
Mailing address
1149 WARREN AVE, VALLEJO, CA 94591-7512
(707) 552-5295
(707) 552-3394
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
480005AN
CA
Other
Enumeration date
11/27/2006
Last updated
03/21/2018
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