NPIMap

Organization Active NPI

Second Genesis, Inc

  • Substance Abuse Rehabilitation Facility
  • Crownsville, MD
National Provider Identifier
1053589242
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SECOND GENESIS, INC
Practice address
107 Circle Dr
Tarditional
Crownsville, MD 21032-2061
Phone
(301) 621-9013
Fax
(301) 563-1546
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. J Michael McGuinness, MSW
Title
Executive Director
Phone
(301) 563-1545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

107 Circle Dr
Tarditional
Crownsville, MD 21032-2061

Mailing address

8611 2ND Ave
Silver Spring, MD 20910-3372
Phone (301) 563-1545

National Provider Directory

National Provider Directory
Tax ID family
Second Genesis Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

107 Circle Dr
Crownsville, MD 21032
Phone (301) 621-9013

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1053589242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 2ND AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103372",
            "telephone_number": "301-563-1545",
            "fax_number": "301-563-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CIRCLE DR",
            "address_2": "TARDITIONAL",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322061",
            "telephone_number": "301-621-9013",
            "fax_number": "301-563-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND GENESIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "MCGUINNESS",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-563-1545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crownsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.