Organization · Type 2 NPI

Genesis Family Home

Emotionally Disturbed Childrens' Residential Treatment Facility · Concord, NC

NPI number 1104044353 Active

Practice location

484 Cook St NW
Concord, NC 28025-4441

Call (704) 793-9593 Map

Mailing address

1036 Branchview Dr, Suite
Concord, NC 28025-2998

Specialties and licenses

Taxonomy	Code	License
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	MHL-013-096 (NC)

Emotionally Disturbed Childrens' Residential Treatment Facility: 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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About NPI 1104044353

Genesis Family Home's National Provider Identifier is 1104044353, issued on Apr 23, 2007. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Concord, NC. The record was last updated on Jun 13, 2008.