# GENESIS THERAPEUTIC SERVICES, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1497882195
- **Authorized official:** KENDRICK ROGERS (PROGRAM DIRECTOR)
- **Authorized official phone:** (910) 577-8200

## Contact information

- **Practice address:** 99 VILLAGE DR STE 12, JACKSONVILLE, NC 28546-7060
- **Practice address phone:** (910) 577-8200
- **Practice address fax:** (910) 577-8270
- **Mailing address:** 99 VILLAGE DR STE 12, JACKSONVILLE, NC 28546-7060
- **Mailing address phone:** (910) 577-8200
- **Mailing address fax:** (910) 577-8270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-067-165 | NC | Yes |

## Other

- **Enumeration date:** 02/28/2007
- **Last updated:** 08/22/2020