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Genesis Family Home
Emotionally Disturbed Childrens' Residential Treatment Facility in Concord, North Carolina
NPI 1104044353

Genesis Family Home is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Concord, NC. Genesis Family Home practices in Concord, NC. The NPI Number for Genesis Family Home is 1104044353 and holds a License No. MHL-013-096 (North Carolina).

The current practice location address for Genesis Family Home is 484 Cook St Nw, Concord, NC and can be reached out via phone at 704-793-9593.

Location: 484 Cook St Nw, Concord, NC, 28025-2998
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104044353
Provider Name
Genesis Family Home
Credential
Provider Entity Type
Organization
Address
484 Cook St Nw, Concord, NC, 28025-2998
Phone Number
704-793-9593
Fax Number
Provider Enumeration Date
04/23/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6603333 05 NC
institution
Provider Business Practice Location Address Details
Address
484 Cook St Nw
City
Concord
State
North Carolina
Zip
28025-4441
Phone Number
704-793-9593
Fax Number
person
Provider Business Mailing Address Details
Address
484 Cook St Nw
City
Concord
State
North Carolina
Zip
28025-4441
Phone Number
704-793-9593
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
MHL-013-096 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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