Organization
NEW GENESISI RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARNOLD ENGLAND (CHIEF EXECUTIVE OFFICER)
(336) 432-3190
Entity
Organization
Contact information
Practice address
300 DOWNEY PL, GASTONIA, NC 28054-3903
(704) 691-1526
Mailing address
1613 W GARRISON BLVD, GASTONIA, NC 28052-3635
(704) 687-9001
(704) 867-9099
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL 036 238
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603968
—
NC
Enumeration date
03/28/2007
Last updated
08/22/2020
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