GENESIS FAMILY HOME (NPI# 1013132620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013132620 |
| Entity Type | Organization |
| Organization Name | GENESIS FAMILY HOME |
| Practice Address |
1224 Milton Ave Kannapolis NC 28081-5444 |
| Mailing Address |
1036 Branchview Dr Suite 201 Concord NC 28025-2998 |
| Practice Telephone | 7047939593 |
| Mailing Telephone | 7047939593 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-30 |
| Authorized Official Name | MR. JOHN KENNEDY EDMOND SR. (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7047939593 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-013-107 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603560 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104044353 | Genesis Family Home | Residential Treatment Facility, Emotionally Disturbed Children | 484 Cook St Nw, Concord, NC 28025-4441 | 2007-04-23 |
| 1649495243 | Genesis Family Home | Residential Treatment Facility, Emotionally Disturbed Children | 514 Todd Dr Ne, Concord, NC 28025-3135 | 2007-04-17 |
| 1629299532 | Genesis Family Home | Residential Treatment Facility, Emotionally Disturbed Children | 1036 Branchview Dr, Suite 201, Concord, NC 28025-2998 | 2007-05-01 |
| Street Address |
1224 MILTON AVE |
| City | KANNAPOLIS |
| State | NC |
| Zip Code | 28081-5444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678315 | Cabarrus Al Holdings, LLC | Non-emergency Medical Transport (VAN) | 4968 Milestone Ave, Kannapolis, NC 28081 | 2019-06-18 |
| 1245755222 | Jennifer Ann Drisker | Social Worker | 119 West Avenue, Kannapolis, NC 28081 | 2017-08-10 |
| 1720539059 | Bonnie Knox | Non-emergency Medical Transport (VAN) | 902 South Main St, Kannapolis, NC 28081 | 2016-10-21 |
| 1659643880 | Jonathan Redmond | Occupational Therapy Assistant | 7555 Tuckaseegee Rd, Kannapolis, NC 28081 | 2012-02-03 |
| 1245465145 | Margot C Dragon | Acupuncturist | 7560 Crestwood Drive, Kannapolis, NC 28081 | 2009-05-20 |
| 1154542124 | Robert Lee Dayvault Jr. | Pharmacist | 1113 N. Main St., Kannapolis, NC 28081 | 2007-05-01 |
| 1265573745 | Cardinal Innovations Healthcare Solutions | Community/Behavioral Health | 4855 Milestone Avenue, Kannapolis, NC 28081 | 2007-02-09 |
| 1245331016 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 135 Dale Earnhardt Boulevard, Kannapolis, NC 28081 | 2006-09-26 |
| 1003844887 | Randal G Troutman | Chiropractor | 1715 S. Main Street, Kannapolis, NC 28081 | 2006-06-29 |
| 1457332728 | James M Bowman | Pharmacist | 1113 N Main St, Kannapolis, NC 28081 | 2005-11-14 |
| Find all providers in zip 28081 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215061007 | Youth Adult Care Management | Residential Treatment Facility, Emotionally Disturbed Children | 730 Jack St, Kannapolis, NC 28081-9573 | 2007-03-15 |
| 1649304437 | Youth Adult Care Management | Residential Treatment Facility, Emotionally Disturbed Children | 1906 Woodlawn St, Kannapolis, NC 28083-3058 | 2007-03-15 |
| 1497889281 | Youth Adult Care Management | Residential Treatment Facility, Emotionally Disturbed Children | 1680 Barbara Ann Cir, Kannapolis, NC 28083-6574 | 2007-03-15 |
| 1083763106 | Progressions 4 | Residential Treatment Facility, Emotionally Disturbed Children | 126 Ashmont Dr, Kannapolis, NC 28081-7134 | 2007-01-09 |
| 1942421862 | Youth Adult Care Management | Residential Treatment Facility, Emotionally Disturbed Children | 1605 Old Earnhardt Rd, Kannapolis, NC 28083-8025 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| Find all providers with the same taxonomy | ||||
| City | KANNAPOLIS |
| Zip Code | 28081 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.