Organization
GENESIS COMMUNITY HEALTH, INC.
Active
Other names
Boca Raton Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA M WARREN (PRESIDENT/CEO)
(561) 735-6553
Entity
Organization
Contact information
Practice address
181 CRAWFORD BLVD FL 1, BOCA RATON, FL 33432-3743
(561) 235-5477
(561) 770-1940
Mailing address
639 E OCEAN AVE STE 409, BOYNTON BEACH, FL 33435-5017
(561) 806-6835
(561) 806-6607
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006608603
—
FL
Enumeration date
04/15/2013
Last updated
11/04/2024
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