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General NPI Number Information
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NPI Number | 1598135774
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Entity Type | Organization
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Legal Business Name | GENESIS THERAPEUTICAL SERVICES, INC.
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 5721 SW 13TH TER
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City | WEST MIAMI
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State | FL
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Zip | 33144-5705
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Country | US
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Telephone | 786-312-4804
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Fax |
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Provider Business Mailing Address
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Address Line | 5721 SW 13TH TERRACE
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 786-312-4804
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YAYMA ADAMES
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Credential |
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Telephone | 386-315-6339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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