Genesis House Bloomsburg

LBN: Genesis House Bloomsburg
Genesis House Bloomsburg is an health care organization with primary practice located at 320 East Second Street , Bloomsburg PA 17815. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Genesis House Bloomsburg can be contacted via phone (570) 784-4073, or through Desanto, James Robert via phone (370) 322-0520.

Contact Information

Primary practice address
320 East Second Street Bloomsburg PA 17815
Phone: (570) 784-4073
Fax: (570) 704-4592
Website:
Map and Directions
Authorized official contact:
Name: Desanto, James Robert LSW CCOPD
Phone: (370) 322-0520

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 197052 Pennsylvania

Profile Details

NPI number 1518124783
LBN Legal business name Genesis House Bloomsburg
DBA Doing business as
Authorized official Desanto, James Robert LSW CCOPD
Entity Organization
Organization subpart 1 Yes
Enumeration date May 16th, 2008
Last updated May 16th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518124783 NPPES
Pennsylvania MEDICAID 1007283800

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