Genrev Family Resource

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH4495 Issued in AZ

Legal business name

GENREV FAMILY RESOURCE

Practice address

8537 W Wilshire Dr
Phoenix, AZ 85037-3710

Phone

(602) 505-2683

NPI assigned

Jan 7, 2015

Organization subpart

No

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

Authorized official

Name

Darnell Colbert

Title

Ceo

Phone

(602) 505-2683

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1730577263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 E THOMAS RD STE 9",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8537 W WILSHIRE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373710",
            "telephone_number": "602-505-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENREV FAMILY RESOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "DARNELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-505-2683"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH4495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE",
            "identifier": "BH4495",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
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• Genomic Health Inc.
• Genopre Inc
• Paola V. Genovese, MD
• Steven Michael Genrich, D.PH.
• Tashi Genshock
• Cayla Gensler
• Javier Ignacio Gentile, M.D.
• Gentle Hands Dentistry LLC

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.