MEDICARE: GENESIS CENTERS

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
1	101YP2500X	Professional Counselor	19430	TX

General Provider Information

NPI Number	:	1659409472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS CENTERS

Provider Business Mailing Address
First Line	:	PO BOX 2148
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-0038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1546 CHARLESTON DR
Second Line	:	A
City	:	ALLEN
State	:	TX
Zip	:	75002-0913
Country	:	US
Telephone Number	:	214-288-8878
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KATYNA CHRISTIAN
Credential	:
Telephone Number	:	214-288-8878

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	08/22/2020

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Directions to “GENESIS CENTERS ” Practice Location

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