| NPI | 1619741915 |
|---|---|
| Doing Business As | GENERATION GERANNAMO |
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE JORDAN CEO 267-789-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-12 |