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Contact Information

GENESIS HOUSE, INC.
549 COX RD
SUITE A
GASTONIA, NC28054-0628
 Phone: 704-852-3778
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
 

Community/Behavioral Health

251S00000X
 

Mental Health

101YM0800X
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for GENESIS HOUSE, INC.

NPI # 1487958716
LBN Legal business name GENESIS HOUSE, INC.
Authorized official KELVIN HALL - (PRESIDENT/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/30/2010
Last updated 04/11/2012 - About 14 years ago
Identifiers
NC Medicaid 5914113
NC Medicaid 6002315
NC Medicaid 6005952
NC Medicaid 8300892G
NC Medicaid 8300892H
NC Medicaid 8300892V
NC Medicaid 8302550
NC Medicaid 8302550V
NC Medicaid 8303041R
NC Medicaid 8702052
NC Medicaid 8703125
NC Medicaid 8921979
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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