Organization
GENESIS YOUTH CRISIS CENTER, INC.
Active
Other names
Ridgeline Children's Shelter
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD MATTHEW RUDDER (CHIEF EXECUTIVE OFFICER)
(304) 622-1907
Entity
Organization
Contact information
Practice address
413 CHESTNUT STREET, PARSONS, WV 26287
(304) 709-7020
(304) 399-9115
Mailing address
PO BOX 546, CLARKSBURG, WV 26302
(304) 622-1907
(304) 623-9346
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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