Provider Demographics
NPI:1184423972
Name:2ND GENESIS FOUNDATION
Entity type:Organization
Organization Name:2ND GENESIS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINKS
Authorized Official - Suffix:
Authorized Official - Credentials:MA EDD
Authorized Official - Phone:314-482-4993
Mailing Address - Street 1:222 S MERAMEC AVE STE 202-1126
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1805
Mailing Address - Country:US
Mailing Address - Phone:844-524-0234
Mailing Address - Fax:
Practice Address - Street 1:222 S MERAMEC AVE STE 202-1126
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1805
Practice Address - Country:US
Practice Address - Phone:844-524-0234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health