# GENESIS

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

## Provider details

- **NPI number:** 1336273945
- **Authorized official:** MARVIN B KAYE LPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (336) 789-5542

## Contact information

- **Practice address:** 2206 RIDGE CREST LN, MOUNT AIRY, NC 27030-2483
- **Practice address phone:** (336) 786-9132
- **Mailing address:** 419 SPRING ST, MOUNT AIRY, NC 27030-4635

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 4768 | NC | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020