Organization
GENESIS DETOX OF BROOKLYN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL BENITEZ (MANAGING PARTNER/CEO)
(718) 633-4673
Entity
Organization
Contact information
Practice address
449 39TH ST, BROOKLYN, NY 11232-2909
(718) 633-4673
(929) 250-2332
Mailing address
449 39TH ST # 6, BROOKLYN, NY 11232-2909
(718) 633-4673
(929) 250-2332
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/28/2016
Last updated
08/22/2023
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