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Contact Information

GENESISHOUSE, INC.
549 COX RD
SUITE A
GASTONIA, NC28054-0628
 Phone: 704-852-3778
 Fax: 704-853-8751
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for GENESISHOUSE, INC.

NPI # 1093727893
LBN Legal business name GENESISHOUSE, INC.
Authorized official KELVIN HALL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/12/2006
Last updated 06/29/2011 - About 15 years ago
Identifiers
NC License # 9401389
NC Medicaid 3418147
NC Medicaid 6102216
NC Medicaid 8300892
NC Medicaid 8300892B
NC Medicaid 8300892G
NC Medicaid 8300892V
NC Medicaid 8303041
NC Medicaid 8303041R
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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