Second Genesis, Inc. is a primary clinic (Substance Abuse Rehabilitation Facility) in Crownsville, Maryland. The current practice location for Second Genesis, Inc. is 107 Circle Dr, Crownsville, Maryland. For appointments, you can reach them via phone at
(301) 621-9013. The mailing address for Second Genesis, Inc. is 8611 2nd Ave, Suite 300, Silver Spring, Maryland and phone number is (301) 563-1545.
Second Genesis, Inc. is licensed to practice in Maryland (license number 1053589242) and its
NPI number is 1427352681. This medical practice
does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at
(301) 621-9013.
Primary Care Clinic Profile
| Full Name | Second Genesis, Inc. |
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| Speciality | Substance Abuse Rehabilitation Facility |
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| Location | 107 Circle Dr, Crownsville, Maryland |
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| Authorized Official Name and Position | Mark Segal (DIRECTOR OF CLINICAL OPERATIONS) |
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| Authorized Official Contact | 3015631545 |
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| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Second Genesis, Inc.
8611 2nd Ave
Suite 300
Silver Spring
MD 20910-3372
Ph: (301) 563-1545 | Second Genesis, Inc.
107 Circle Dr
Crownsville
MD 21032-2061
Ph: (301) 621-9013 |
NPI Details:
| NPI Number | 1427352681 |
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| Provider Enumeration Date | 01/03/2011 |
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| Last Update Date | 01/03/2011 |
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Medical Identifiers
Medical identifiers for Second Genesis, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1427352681 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261Q00000X | Clinic/center | 904039 (Maryland) | Secondary |
| 261QR0401X | Clinic/center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (corf) | 904039 (Maryland) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | 904039 (Maryland) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | 1053589242 (Maryland) | Primary |
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