Healthcare Provider Details

I. General information

NPI: 1669327045
Provider Name (Legal Business Name): NEW GENESIS MENTAL HEALTH AND RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SUDBURY DR
KETTERING OH
45420-1129
US

IV. Provider business mailing address

PO BOX 573
SPRINGBORO OH
45066-0573
US

V. Phone/Fax

Practice location:
  • Phone: 937-668-6819
  • Fax:
Mailing address:
  • Phone: 937-668-6819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA M BROWN
Title or Position: OWNER
Credential: LSW
Phone: 937-668-6819