| Genesis...a New Beginning | |
|
245 Le Phillip Ct Ne Concord NC 28025-2900 | |
| (704) 720-7770 | |
| (704) 973-9187 |
| Full Name | Genesis...a New Beginning |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 245 Le Phillip Ct Ne, Concord, North Carolina |
| Authorized Official Name and Position | Donna B Wise (PRESIDENT) |
| Authorized Official Contact | 7047207770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis...a New Beginning 245 Le Phillip Ct Ne Concord NC 28025-2900 Ph: (704) 720-7770 | Genesis...a New Beginning 245 Le Phillip Ct Ne Concord NC 28025-2900 Ph: (704) 720-7770 |
| NPI Number | 1144311853 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 07/09/2021 |
| Certification Date | 07/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144311853 | NPI | - | NPPES |
| 6005393 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | MHL-013-124 (North Carolina) | Primary |
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