| NPI | 1568871663 |
|---|---|
| Other Name | GENESIS CLUB, INC. |
| Entity Type | Organization |
| Authorized Contact | KEVIN L BRADLEY Executive Director 508-831-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2018-06-20 |