GENESIS RESIDENTIAL CARE CENTER, LLC (NPI# 1134555311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134555311 |
| Entity Type | Organization |
| Organization Name | GENESIS RESIDENTIAL CARE CENTER, LLC |
| Practice Address |
236 N Mebane St Burlington NC 27217-3966 |
| Mailing Address |
Po Box 1966 Burlington NC 27216-1966 |
| Practice Telephone | 3365122114 |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |
| Authorized Official Name | MRS. VIVIAN HAITH TIMMONS (CEO) |
| Authorized Official Telephone | 3365122114 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-001-148 | NC | Residential Treatment Facilities |
| Street Address |
236 N MEBANE ST |
| City | BURLINGTON |
| State | NC |
| Zip Code | 27217-3966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285787119 | Cora Adams Strickland X | Counselor | 236 N Mebane St, Suite 101, Burlington, NC 27217-3966 | 2007-01-22 |
| 1992129555 | Sherry Thompson | Social Worker | 236 N Mebane St, Burlington, NC 27217-3966 | 2014-02-18 |
| 1114207958 | Raina Kathleen Roper | Social Worker | 236 N Mebane St, Suite 101, Burlington, NC 27217-3966 | 2011-08-25 |
| 1316241201 | Solutions Community Support Agency LLC | Counselor | 236 N Mebane St, Suite 101, Burlington, NC 27217-3966 | 2011-01-06 |
| 1932422987 | Essence of Care, Inc | Community/Behavioral Health | 236 N Mebane St, Suite 120, Burlington, NC 27217-3966 | 2010-03-04 |
| 1750618088 | Cnc/access Inc | In Home Supportive Care | 236 N Mebane St, Suite 102, Burlington, NC 27217-3966 | 2009-11-06 |
| 1932436268 | Cnc/access Inc | Community/Behavioral Health | 236 N Mebane St, Suite 102, Burlington, NC 27217-3966 | 2009-11-06 |
| 1548403652 | Cnc Access Inc | Community/Behavioral Health | 236 N Mebane St, Suite 102, Burlington, NC 27217-3966 | 2009-04-20 |
| 1184867277 | Cnc Access Inc | Community/Behavioral Health | 236 N Mebane St, Suite 102, Burlington, NC 27217-3966 | 2009-04-20 |
| 1093958100 | Cnc Access Inc | Community/Behavioral Health | 236 N Mebane St, Suite 105, Burlington, NC 27217-3966 | 2009-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174027197 | Robin Kecia Mann | Technician | 5044 George Miles Road, Burlington, NC 27217 | 2018-03-23 |
| 1003319302 | Universal Mental Health Services, Inc. | In Home Supportive Care | 2539 Hyde Street, Burlington, NC 27217 | 2018-03-13 |
| 1992229827 | Seth Isaac Barry | Pharmacist | 1009 W Main St., Burlington, NC 27217 | 2017-08-02 |
| 1639626153 | Nicole Spencer | Registered Nurse | 5270 Union Ridge Road, Burlington, NC 27217 | 2016-09-01 |
| 1649623869 | Deinyell Chelley | Community Health Worker | 2536 Mckinney Street, Burlington, NC 27217 | 2016-07-22 |
| 1093157240 | Alamance Academy, LLC | Community/Behavioral Health | 530 Rosenwald St, Burlington, NC 27217 | 2013-07-29 |
| 1063851897 | Talley Family Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2266 Fitch Road, Burlington, NC 27217 | 2013-06-14 |
| 1851739643 | Falcon Crest Residential | Community/Behavioral Health | 3309a N Nc Highway 49, Burlington, NC 27217 | 2013-06-13 |
| 1033554878 | Janice Putnam | Dietitian, Registered | 319 N Graham - Hopedale Road, Burlington, NC 27217 | 2013-05-07 |
| 1811226723 | Moving Forward | Community/Behavioral Health | 1146 N. Church St., Ste. A, Burlington, NC 27217 | 2009-12-24 |
| Find all providers in zip 27217 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891357752 | New Hope for Tomorrow LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Baldwin Rd, Burlington, NC 27217-1702 | 2019-07-01 |
| 1639605843 | Just In Time Youth Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 432 W 5th St, Burlington, NC 27215-3832 | 2017-05-08 |
| 1962825489 | Signal Diymoke White | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 164 Graves St, Burlington, NC 27217-2628 | 2014-02-04 |
| 1063851897 | Talley Family Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2266 Fitch Road, Burlington, NC 27217 | 2013-06-14 |
| 1225302425 | Creative Directions Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 325 Hall Ave, Burlington, NC 27217-2313 | 2012-03-06 |
| 1538446232 | Triad Health Care Services #2 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 603 Pinnix Rd, Burlington, NC 27217-8555 | 2011-11-08 |
| 1386956183 | Lord Is The Light | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2802 Eldermont St, Apt E, Burlington, NC 27215-6111 | 2010-07-08 |
| 1346571304 | Blackwell's Community Living LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 426 Somers Ave, Burlington, NC 27215-2032 | 2010-01-14 |
| 1881890788 | Hope Haven Cottonwood | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 910 Cottonwood Ct Ste 1002, Burlington, IA 52601-1994 | 2007-06-26 |
| 1144354614 | Hope Haven Area Development Center Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2205 Northern Dr, Burlington, IA 52601-2256 | 2007-03-15 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 27217 |
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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.