Genesis Family Home

LBN: Genesis Family Home
Genesis Family Home is an health care organization with primary practice located at 484 Cook St Nw , Concord NC 28025-4441. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Genesis Family Home can be contacted via phone (704) 793-9593, or through Edmond, John Kennedy via phone (704) 793-9593.

Contact Information

Primary practice address
484 Cook St Nw Concord NC 28025-4441
Phone: (704) 793-9593
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Edmond, John Kennedy
Phone: (704) 793-9593

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL-013-096 North Carolina

Profile Details

NPI number 1104044353
LBN Legal business name Genesis Family Home
DBA Doing business as
Authorized official Edmond, John Kennedy
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2007
Last updated Jun 13th, 2008 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104044353 NPPES
North Carolina MEDICAID 6603333

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