Second Genesis, INC

NPI #1316115454 in Upper Marlboro, Maryland

Provider Information

NPI Number: 1316115454
Entity Type: Organization
Organization Name: Second Genesis, INC
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Feb 12, 2008
Last Updated: Feb 12, 2008

Practice Location

Address: 4620 MELWOOD RD
City: Upper Marlboro
State: Maryland
ZIP Code: 20772-9507
Phone: (301) 563-1545

Authorized Official

Name: MR. J MICHAEL MCGUINNESS, MSW
Title: EXECUTIVE DIRECTOR
Phone: (301) 563-1545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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