Organization
GENESIS PROJECT 1
Active
Organization
GENESIS PROJECT 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRASHA BLACK PHD (CLINICAL DIRECTOR)
(704) 596-0505
Entity
Organization
Contact information
Practice address
5108 REAGAN DR, SUITE 14, CHARLOTTE, NC 28206-3103
(704) 596-0505
(704) 596-0507
Mailing address
5108 REAGAN DR, SUITE 14, CHARLOTTE, NC 28206-3103
(704) 596-0505
(704) 596-0507
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
P009049
NC
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up