GENESIS FAMILY HOME (NPI# 1649495243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649495243 |
| Entity Type | Organization |
| Organization Name | GENESIS FAMILY HOME |
| Practice Address |
514 Todd Dr Ne Concord NC 28025-3135 |
| 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-013-060 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603176 | 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 |
| 1013132620 | Genesis Family Home | Residential Treatment Facility, Emotionally Disturbed Children | 1224 Milton Ave, Kannapolis, NC 28081-5444 | 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 |
514 TODD DR NE |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336429786 | Rha Health Services Nc, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 514 Todd Dr Ne, Concord, NC 28025-3135 | 2011-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| 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 |
|---|---|---|---|---|
| 1699951541 | Rolfe and Rumford Home | Residential Treatment Facility, Emotionally Disturbed Children | 23 Rundlett St, Concord, NH 03301-2223 | 2008-01-10 |
| 1215159694 | Tobey School | Residential Treatment Facility, Emotionally Disturbed Children | 45 S Fruit St, Concord, NH 03301-2410 | 2007-05-03 |
| 1407076334 | Horizon Care, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 426 Church St N, Suite 210, Concord, NC 28025-4548 | 2007-04-25 |
| 1104044353 | Genesis Family Home | Residential Treatment Facility, Emotionally Disturbed Children | 484 Cook St Nw, Concord, NC 28025-4441 | 2007-04-23 |
| 1639203326 | Youth Adult Care Management | Residential Treatment Facility, Emotionally Disturbed Children | 491 Liberty Drive, Concord, NC 28025-6318 | 2007-03-15 |
| 1427182211 | Youth Adult Care Management | Residential Treatment Facility, Emotionally Disturbed Children | 1395 Mistletoe Ridge Pl Nw, Concord, NC 28027-7877 | 2007-03-15 |
| 1558410415 | Progressions 1- Treasure Place | Residential Treatment Facility, Emotionally Disturbed Children | 906 Treasure Pl, Concord, NC 28025-7206 | 2007-01-09 |
| 1700935996 | Progressions Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 196 Church St Ne, Concord, NC 28025-4759 | 2007-01-09 |
| 1265581110 | Progressions 3 - Loch Lomond | Residential Treatment Facility, Emotionally Disturbed Children | 844 Loch Lomond Cir, Concord, NC 28025-0416 | 2007-01-09 |
| 1396894499 | Progressions 2 - Carolina Pointe | Residential Treatment Facility, Emotionally Disturbed Children | 4127 Carolina Pointe Ct, Concord, NC 28027-0410 | 2007-01-09 |
| Find all providers in CONCORD | ||||
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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.