NPIMap

Organization Active NPI

Genesis House, Inc

  • Substance Abuse Rehabilitation Facility
  • Vallejo, CA
National Provider Identifier
1831265495
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
480005AN Issued in CA
Legal business name
GENESIS HOUSE, INC
Practice address
1149 Warren Ave
Vallejo, CA 94591-7512
Phone
(707) 552-5295
Fax
(707) 552-3394
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Authorized official

Name
Mr. Kester Vorett McDonald
Title
Executive Director
Phone
(707) 552-5295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 480005AN CA Primary

Addresses

Primary practice location

1149 Warren Ave
Vallejo, CA 94591-7512

Mailing address

1149 Warren Ave
Vallejo, CA 94591-7512
Phone (707) 552-5295

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1831265495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 WARREN AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917512",
            "telephone_number": "707-552-5295",
            "fax_number": "707-552-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 WARREN AVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917512",
            "telephone_number": "707-552-5295",
            "fax_number": "707-552-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "KESTER",
        "authorized_official_middle_name": "VORETT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-552-5295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "480005AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.