Genesis Community Wellness LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GENESIS COMMUNITY WELLNESS LLC

Practice address

2720 NW 167TH St
Miami Gardens, FL 33054-6400

Phone

(305) 318-7391

NPI assigned

Feb 26, 2020

Organization subpart

No

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

Authorized official

Name

Genesis Abreu EttienneNPI 1548731623

Title

President

Phone

(305) 318-7391

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Genesis Dejesus Abreu Ettienne, LMHC

  • Mental Health Counselor
  • Miramar, FL
  • NPI 1548731623
  NPD Authorized official

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1720612997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546400",
            "telephone_number": "305-318-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546400",
            "telephone_number": "305-318-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COMMUNITY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "ABREU ETTIENNE",
        "authorized_official_first_name": "GENESIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-318-7391"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvalyn Eleanor Gayle, CNA
• GC Quality Home Inc
• Mark Stuart Geltzer, DDS
• Gemini Health Solutions LLC
• Genesis Adult Day Care Inc
• Genesis Mental Health LLC
• Gentle Loving Home Care LLC
• Genuine Love and Care LLC
• Misty Germain
• Jean Kensley Germinal

• Community/Behavioral Health Agency in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.