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NPI Code Detail

MEDICARE: GENESIS II, INC.

MEDICARE: GENESIS II, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency807289PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548302763
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESIS II, INC.
Provider Business Mailing Address
First Line : 1239 SPRING GARDEN ST
Second Line : SUITE 300
City : PHILADELPHIA
State : PA
Zip : 19123-3206
Country : US
Telephone Number : 215-978-5191
Fax Number : 215-978-8017
Provider Business Practice Location Address
First Line : 1239 SPRING GARDEN ST
Second Line : SUITE 300
City : PHILADELPHIA
State : PA
Zip : 19123-3206
Country : US
Telephone Number : 215-978-5191
Fax Number : 215-978-8017
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. MICHAEL GOLD
Credential :
Telephone Number : 215-978-5191
Provider Enumeration Date : 02/13/2007
Last Update Date : 08/22/2020

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Directions to “GENESIS II, INC. ” Practice Location

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