| Genesis House, Inc | |
|
823 Central Road Bloomsburg PA 17815 | |
| (570) 322-0520 | |
| (570) 326-9674 |
| Full Name | Genesis House, Inc |
|---|---|
| Speciality | Public Health Or Welfare |
| Location | 823 Central Road, Bloomsburg, Pennsylvania |
| Authorized Official Name and Position | Shakeena Bernique Lee (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5703220520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis House, Inc 800 West 4th Street Ste G-01 Williamsport PA 17701-7201 Ph: (570) 322-0520 | Genesis House, Inc 823 Central Road Bloomsburg PA 17815 Ph: (570) 322-0520 |
| NPI Number | 1518124783 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 10/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518124783 | NPI | - | NPPES |
| 1007283800 | Medicaid | PA | |
| 10072838000027 | Medicaid | PA |
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