# NEW GENESISI RESIDENTIAL SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275652430
- **Authorized official:** ARNOLD ENGLAND (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (336) 432-3190

## Contact information

- **Practice address:** 300 DOWNEY PL, GASTONIA, NC 28054-3903
- **Practice address phone:** (704) 691-1526
- **Mailing address:** 1613 W GARRISON BLVD, GASTONIA, NC 28052-3635
- **Mailing address phone:** (704) 687-9001
- **Mailing address fax:** (704) 867-9099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL 036 238 | NC | Yes |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603968 | — | NC |