Organization
FIRST GENESIS FAMILY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS WILLETTE CARRINGTON (ADMINISTRATIVE ASSISTANT)
(336) 292-1555
Entity
Organization
Contact information
Practice address
4821 BISBEE DR, GREENSBORO, NC 27407-9710
(336) 292-1555
Mailing address
1903 DELMAR DR, GREENSBORO, NC 27406-6113
(336) 292-1555
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-041-728
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-041-837
NC
323P00000X
Psychiatric Residential Treatment Facility
MHL-041-728
NC
323P00000X
Psychiatric Residential Treatment Facility
MHL-041-837
NC
Other
Enumeration date
12/17/2009
Last updated
09/16/2015
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