NPIMap

Organization Active NPI

Second Genesis, Inc

  • Children's Substance Abuse Rehabilitation Facility
  • Upper Marlboro, MD
National Provider Identifier
1316115454
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
903298 Issued in MD
Legal business name
SECOND GENESIS, INC
Practice address
4620 Melwood Rd
Upper Marlboro, MD 20772-9507
Phone
(301) 563-1545
Fax
(301) 563-1546
NPI assigned
Feb 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 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
Children's Substance Abuse Rehabilitation Facility 3245S0500X 903298 MD Primary

Addresses

Primary practice location

4620 Melwood Rd
Upper Marlboro, MD 20772-9507

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

4620 Melwood Rd
Upper Marlboro, MD 20772
Phone (301) 563-1545

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1316115454",
    "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": "4620 MELWOOD RD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207729507",
            "telephone_number": "301-563-1545",
            "fax_number": "301-563-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND GENESIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "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": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "MD",
            "license": "903298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.