Whalio Doctors

NPI 1427352681

Second Genesis, INC.

Organisation Substance Abuse Rehabilitation Facility Crownsville, MD

Practice location

Address
107 Circle Dr, Crownsville, MD 21032-2061
Phone
(301) 621-9013
Mailing address
8611 2nd Ave Suite 300, Silver Spring, MD 20910-3372

Authorised official

Name
Mark Segal
Title
Director of Clinical Operations
Phone
(301) 563-1545

Registered specialties (4)

Substance Abuse Rehabilitation Facility Primary
Residential Treatment Facilities Taxonomy 324500000X Licence 1053589242 (MD)
Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261Q00000X Licence 904039 (MD)
Comprehensive Outpatient Rehabilitation Facility (CORF)
Ambulatory Health Care Facilities Taxonomy 261QR0401X Licence 904039 (MD)
Substance Use Disorder Rehabilitation Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QR0405X Licence 904039 (MD)

Registry record

NPI
1427352681
Entity type
Organization
NPI issued
3 Jan 2011
Record last updated
3 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.