# GENESIS YOUTH CRISIS CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ridgeline Children's Shelter
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609383298
- **Authorized official:** EDWARD MATTHEW RUDDER (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (304) 622-1907

## Contact information

- **Practice address:** 413 CHESTNUT STREET, PARSONS, WV 26287
- **Practice address phone:** (304) 709-7020
- **Practice address fax:** (304) 399-9115
- **Mailing address:** PO BOX 546, CLARKSBURG, WV 26302
- **Mailing address phone:** (304) 622-1907
- **Mailing address fax:** (304) 623-9346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/04/2018
- **Last updated:** 01/04/2018