Organization
GENESISDWISERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY DOCKERY CSAC-I (OPERATIONS MANAGER)
(919) 321-6643
Entity
Organization
Contact information
Practice address
35 W DAVIE ST, RALEIGH, NC 27601-1732
(919) 321-6643
(919) 321-8930
Mailing address
35 W DAVIE ST, RALEIGH, NC 27601-1732
(919) 321-6643
(919) 321-8930
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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