Genesis Specialty Groups, LLC
Clinic/Center, Adult Mental Health in Baton Rouge, LA. Organization (NPI-2).
NPI number1033682802
StatusActive
Last updated in NPPESJan 4, 2019
Details
- NPI
- 1033682802
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis Specialty Groups, LLC
- Organization subpart
- No
- Enumeration date
- Jan 4, 2019
- Last updated
- Jan 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
778 Chevelle DriveBaton Rouge, LA 70806
Phone 225-771-8890 · Fax 225-612-6920
Mailing address
Po Box 83581Baton Rouge, LA 70884
Phone 225-771-9980 · Fax 225-612-6420
Authorized official
Tanya Mekdessie Stuart
Owner
2257719980
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