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General NPI Number Information
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NPI Number | 1518775493
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Entity Type | Organization
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Legal Business Name | GENESIS HOPE FOR GROWTH COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 6611 LUCKY FIELDS
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City | CONVERSE
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State | TX
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Zip | 78109
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Country | US
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Telephone | 210-951-9586
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 S WW WHITE RD STE 120 #83
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City | SAN ANTONIO
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State | TX
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Zip | 78220-1519
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Country | US
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Telephone | 210-951-9586
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | EFREM DARRON DEHUGHES
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Credential | LCSW
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Telephone | 210-951-9586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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