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SECOND GENESIS
NPI 1740439603
Clinic/Center - Rehabilitation, Substance Use Disorder in Washington, DC

Active since September 16, 2008
4017 MINNESOTA AVE NE, WASHINGTON, DC 20019(202) 388-8570(202) 388-3523 Get Directions Write a Review

NPPES record last updated: September 16, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Second Genesis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SECOND GENESIS (NPI 1740439603) is a healthcare organization registered as a rehabilitation, substance use disorder in Washington, District Of Columbia and active in the NPI registry since September 2008. The organization lists J. Michael Mcguinness, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1740439603
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameSECOND GENESIS
Location Address4017 MINNESOTA AVE NEWashington, DC 20019-3541
Mailing Address8611 2nd Ave, Suite 300Silver Spring, MD 20910-3372 · (301) 563-1545 · Fax (301) 563-1546
Phone(202) 388-8570
Fax(202) 388-3523
Organization SubpartNo
Authorized OfficialJ. Michael McguinnessExecutive Director · (301) 563-1545
Enumeration DateSeptember 16, 2008
✔ NPI 1740439603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Licenses✔ Licensed in DC · 111507A-Y-170✔ Licensed in DC · 111507A-171
4017 MINNESOTA AVE NE, Washington, DC 20019
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Other Identifiers 4

Medicaid1790766855DC
Medicaid1003084146MD
Medicaid1316115454MD
Medicaid1053589242MD

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALAIN ACHANDUNG
Case Manager/Care Coordinator
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
TATIANA LAURIE POUADEU DJONGOUE
Home Health Aide
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
JUSTLINE TAH
Registered Nurse (Psychiatric/Mental Health, Adult)
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
BRUNO AYONG TAH
Community Health Worker
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
TERENCE AZINWI NIBA TANIFUM
Case Manager/Care Coordinator
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
MONIQUE ELIZABETH STRATTON
Case Manager/Care Coordinator
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
SAMSON SANUSIAGBABIAKA
Case Manager/Care Coordinator
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202
MRS. TARA CATHERINE FLEMING LICSW
Social Worker (Clinical)
4017 MINNESOTA AVE NE
WASHINGTON, DC 20019
District of Columbia (202) 388-9202

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Second Genesis's NPI number?

The NPI number for Second Genesis is 1740439603. It was assigned to this organization in the NPPES registry on September 16, 2008.

Where is Second Genesis located?

Second Genesis is located at 4017 Minnesota Ave NE, Washington, DC 20019. The listed phone number is (202) 388-8570.

What is Second Genesis's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Second Genesis was last updated on September 16, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.