Organization
GENESIS YOUTH & FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA JACKSON (CEO)
(704) 549-4406
Entity
Organization
Contact information
Practice address
9700 RESEARCH DR, SUITE 122, CHARLOTTE, NC 28262-8552
(704) 549-4406
Mailing address
9700 RESEARCH DR, SUITE 122, CHARLOTTE, NC 28262-8552
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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