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Organization

FIRST GENESIS GROUP HOME (DBA) BISBEE PLACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JANICE M CHAMBERS LPC (EXECUTIVE DIRECTOR)
(336) 292-1555
Entity
Organization

Contact information

Practice address
4821 BISBEE DR, GREENSBORO, NC 27407-9710
(336) 292-1555
(336) 274-6608
Mailing address
4309 PENTON PLACE, GREENSBORO, NC 27455-1920
(336) 292-1555
(336) 274-6608

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701003386
VA
101YP2500X
Professional Counselor
4173
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
041837
NC

Other

Enumeration date
10/02/2007
Last updated
10/03/2011
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