GENESIS CLUB HOUSE, INC. (NPI# 1568871663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568871663 |
| Entity Type | Organization |
| Organization Name | GENESIS CLUB HOUSE, INC. |
| Other Organization Name | GENESIS CLUB, INC. |
| Practice Address |
274 Lincoln St Worcester MA 01605-2106 |
| Practice Telephone | 5088310100 |
| Practice Fax Number | 5087531286 |
| Mailing Telephone | 5088310100 |
| Mailing Fax Number | 5087531286 |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | MR. KEVIN L BRADLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5088310100 |
| Authorized Official Credential | M ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Genesis Club, Inc. | Other Name - Individual/Organization |
| Street Address |
274 LINCOLN ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01605-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083228340 | Francisca A Bediako | Registered Nurse | Commonwealth Care Alliance, 100 North Parkway-suite # 202, Worcester, MA 01605 | 2020-09-03 |
| 1922660646 | Jenna Patricia Mullarkey | Counselor | Ummmc, Hahnemann Family Health Center, 279 Lincoln Street, Worcester, MA 01605 | 2019-07-02 |
| 1295219293 | Valerie Ann Wedge | Social Worker | 382 Plantation Street, Worcester, MA 01605 | 2018-09-17 |
| 1154800290 | Keri Innis-grant | Counselor | 108 Grove Street, Ste Ll11, Worcester, MA 01605 | 2018-08-09 |
| 1184119463 | Madiinah Namutebi | Registered Nurse | 56 Olga Ave, Worcester, MA 01605 | 2018-06-28 |
| 1841789310 | Ashley Murray | Psychologist | 361 Plantation St., Attn: Forensic Services, Worcester, MA 01605 | 2018-05-09 |
| 1184126419 | Nadia Saforo | Nurse Practitioner | 509 Plantation St Apt 221, Worcester, MA 01605 | 2018-03-02 |
| 1548779044 | Arnold Kamau Thuku | Behavioral Analyst | 55 Erie Ave, Worcester, MA 01605 | 2017-09-27 |
| 1417466483 | Sabine Erica Charles-arbouet | Registered Nurse | 25 Oriol Drive, Worcester, MA 01605 | 2017-09-21 |
| 1548787864 | Alyssa Lynn Champagne | Behavioral Analyst | 19 Judson Rd, Worcester, MA 01605 | 2017-08-28 |
| Find all providers in zip 01605 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132458 | Autism Behavioral & Therapeutic Services | Community/Behavioral Health | 5 Bedford Ave, Worcester, MA 01604-4707 | 2020-10-20 |
| 1811502966 | R.e.s.t. Counseling Services, LLC | Community/Behavioral Health | 36 Tirrell St # 1, Worcester, MA 01603-2617 | 2020-09-14 |
| 1841820313 | On Watch Counseling Services | Community/Behavioral Health | 316 Plantation St, Worcester, MA 01604-1745 | 2020-01-23 |
| 1194389304 | Autism Therapy & Training Services | Community/Behavioral Health | 1 Longwood Ave, Worcester, MA 01606-3416 | 2019-04-24 |
| 1265909360 | Autism Health Services LLC | Community/Behavioral Health | 5 Nathaniel St, Worcester, MA 01604-1524 | 2018-10-26 |
| 1144733056 | Tamami Amara Okano | Community/Behavioral Health | 500 Massasoit Rd # 2, Worcester, MA 01604-3548 | 2017-11-14 |
| 1346794831 | Abiworcester, LLC | Community/Behavioral Health | 133 Puritan Ave, Worcester, MA 01604-3230 | 2016-08-12 |
| 1730553124 | H.r.i. Clinics Inc - (worcester Location) | Community/Behavioral Health | 411 Chandler St., Arbour Counseling Services Partial Hospital Lization Pr, Worcester, MA 01602 | 2015-11-23 |
| 1811389901 | Autism Intervention Center | Community/Behavioral Health | 2 Naumaan Ln, Worcester, MA 01606-1274 | 2015-02-26 |
| 1851780316 | Families Together LLC | Community/Behavioral Health | 120 Chandler St # 2l, Worcester, MA 01609-2923 | 2015-01-21 |
| Find all providers in WORCESTER | ||||
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| 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.