Organization
GENESIS HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELVIN HALL (PRESIDENT/CEO)
(704) 852-3778
Entity
Organization
Contact information
Practice address
759 THUNDER RD, SPINDALE, NC 28160-1160
(828) 288-8801
(828) 288-8803
Mailing address
1528 UNION RD, GASTONIA, NC 28054-2200
(704) 852-3778
(704) 853-8751
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302550B
—
NC
Enumeration date
04/21/2009
Last updated
04/21/2009
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