GENESIS HOUSE RECOVERY RESIDENCE INC. (NPI# 1245383447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245383447 |
| Entity Type | Organization |
| Organization Name | GENESIS HOUSE RECOVERY RESIDENCE INC. |
| Practice Address |
4865 40th Way S Lake Worth FL 33461-5301 |
| Practice Telephone | 5614394070 |
| Practice Fax Number | 5614394864 |
| Mailing Telephone | 5614394070 |
| Mailing Fax Number | 5614394864 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JAMES ANTHONY DODGE (EXEUTIVE DIRECTOR) |
| Authorized Official Telephone | 5614394070 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 0950AD652501 | FL | Residential Treatment Facilities |
| Street Address |
4865 40TH WAY S |
| City | LAKE WORTH |
| State | FL |
| Zip Code | 33461-5301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457726994 | Gensis House Recovery Residence Inc. | Substance Abuse Rehabilitation Facility | 4865 40th Way S, Lake Worth, FL 33461-5301 | 2015-12-09 |
| 1396143863 | Stephen Adams | Social Worker | 4865 40th Way S, Lake Worth, FL 33461-5301 | 2014-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167993 | Pcc Medical Holdings LLC | Health Maintenance Organization | 5055 South Congress Avenue, Suite 303, Lake Worth, FL 33461 | 2019-11-05 |
| 1841849692 | Five Star Medical Group Inc | Clinic/Center | 4300 10th Ave North, Suite 2, Lake Worth, FL 33461 | 2019-09-04 |
| 1346894375 | Patrick Pierre Jr. | Behavioral Analyst | 2430 Lake Worth Rd, Apt 2306, Lake Worth, FL 33461 | 2019-07-29 |
| 1740842699 | Amanda Shaw | Massage Therapist | 822 Lynnwood Dr, Lake Worth, FL 33461 | 2019-07-01 |
| 1043706005 | Elina Aguero Arman | Case Manager/Care Coordinator | 420 Alemeda Dr, Palm Springs, FL 33461 | 2018-07-02 |
| 1275028656 | Cagigas Dental Services Inc | Clinic/Center | 2311 10th Avenue North Suite 14, Lake Worth, FL 33461 | 2018-06-27 |
| 1972028447 | Annette Daley | Behavior Technician | 3595 2nd Ave North, Palm Springs, FL 33461 | 2017-08-07 |
| 1104349471 | Safe At Home Health Care, LLC | In Home Supportive Care | 555 Purdy Ln. #215, Palm Springs, FL 33461 | 2017-07-19 |
| 1609307271 | Yadira Perera | Assistant Behavior Analyst | 500 Davis Rd 42a, Palm Springs, FL 33461 | 2017-03-24 |
| 1982155842 | Palm Beach Addiction Center, Inc | Substance Abuse Rehabilitation Facility | 4196 Lake Worth Road, Lake Worth, FL 33461 | 2016-10-17 |
| Find all providers in zip 33461 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447795018 | Suncoast Detox LLC | Substance Abuse Rehabilitation Facility | 9935 Palomino Dr, Lake Worth, FL 33467-1014 | 2017-01-05 |
| 1982155842 | Palm Beach Addiction Center, Inc | Substance Abuse Rehabilitation Facility | 4196 Lake Worth Road, Lake Worth, FL 33461 | 2016-10-17 |
| 1104376565 | Oasis Recovery & Wellness | Substance Abuse Rehabilitation Facility | 7350 Lake Worth Rd, Lake Worth, FL 33467-2529 | 2016-10-10 |
| 1205384914 | Transcendence Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 1530 N Federal Hwy, Lake Worth, FL 33460-1965 | 2016-09-12 |
| 1700231800 | Seaside Treatment Center Inc. | Substance Abuse Rehabilitation Facility | 1028 N Federal Hwy, Lake Worth, FL 33460-2352 | 2016-04-27 |
| 1699193300 | Dukens Place LLC | Substance Abuse Rehabilitation Facility | 5727 Lincoln Cir E, Lake Worth, FL 33463-6758 | 2014-03-31 |
| 1205259975 | New Directions 2.0 LLC | Substance Abuse Rehabilitation Facility | 2290 10th Ave North Ste 201, Lake Worth, FL 33461 | 2014-01-30 |
| 1932539319 | Center for Alcohol and Drug Studies, Inc. | Substance Abuse Rehabilitation Facility | 7613-7625 Lake Worth Road, Lake Worth, FL 33467 | 2013-11-20 |
| 1538500897 | South Florida Treatment Center | Substance Abuse Rehabilitation Facility | 3360 Gondolier Way, Lake Worth, FL 33462-3622 | 2013-07-15 |
| 1598003055 | The Enclave House Inc | Substance Abuse Rehabilitation Facility | 115 Akron St, Unit B, Lake Worth, FL 33461-4808 | 2013-01-17 |
| Find all providers in LAKE WORTH | ||||
| City | LAKE WORTH |
| Zip Code | 33461 |
Please comment or provide details below to improve the information on GENESIS HOUSE RECOVERY RESIDENCE INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.