Genesis Ketamine Centers

LBN: Genesis Ketamine Centers
Genesis Ketamine Centers is an health care organization with primary practice located at 1 Bala Ave Ste 418 , Bala Cynwyd PA 19004-3207. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Ambulatory Health Care Facilities / Multi-Specialty. Allopathic & Osteopathic Physicians / Anesthesiology is the primary health care specialty. Genesis Ketamine Centers can be contacted via phone (267) 361-0315, or through Shaw, Kelly via phone (267) 361-0315.

Contact Information

Primary practice address
1 Bala Ave Ste 418 Bala Cynwyd PA 19004-3207
Phone: (267) 361-0315
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Shaw, Kelly
Phone: (267) 361-0315

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1730886888
LBN Legal business name Genesis Ketamine Centers
DBA Doing business as
Authorized official Shaw, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date Feb 9th, 2023
Last updated Feb 9th, 2023 - about 2 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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