institution
Second Genesis
Substance Use Disorder Rehabilitation Clinic/Center in Washington, District of Columbia
NPI 1740439603

Second Genesis is a Substance Use Disorder Rehabilitation Clinic/Center based in Silver Spring, DC and is specialized in Rehabilitation, Substance Use Disorder. Second Genesis practices in Washington, DC. The NPI Number for Second Genesis is 1740439603 and holds a License No. 111507A-Y-170 (District of Columbia).

The current practice location address for Second Genesis is 4017 Minnesota Ave Ne, Washington, DC and can be reached out via phone at 202-388-8570 and via fax at 202-388-3523.

Location: 4017 Minnesota Ave Ne, Washington, DC, 20910-3372
institution
Provider Profile Details
NPI Number
1740439603
Provider Name
Second Genesis
Credential
Provider Entity Type
Organization
Address
4017 Minnesota Ave Ne, Washington, DC, 20910-3372
Phone Number
202-388-8570
Fax Number
202-388-3523
Provider Enumeration Date
09/16/2008
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1316115454 05 MD
1003084146 05 MD
1053589242 05 MD
1790766855 05 DC
institution
Provider Business Practice Location Address Details
Address
4017 Minnesota Ave Ne
City
State
Zip
20019-3541
Phone Number
202-388-8570
Fax Number
202-388-3523
person
Provider Business Mailing Address Details
Address
4017 Minnesota Ave Ne
City
State
Zip
20019-3541
Phone Number
202-388-8570
Fax Number
202-388-3523
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
License No.
111507A-Y-170 (District of Columbia)
Definition
Definition to come...
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