Healthcare Provider Details

I. General information

NPI: 1720118672
Provider Name (Legal Business Name): GENESIS FAMILY HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 HAMILTON PLACE 107
HIGH POINT NC
27262-2600
US

IV. Provider business mailing address

1320 HAMILTON PLACE SUITE # 107
HIGH POINT NC
27262
US

V. Phone/Fax

Practice location:
  • Phone: 336-885-1830
  • Fax: 336-885-1837
Mailing address:
  • Phone: 336-885-1830
  • Fax: 336-885-1837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1883
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JAMES E COLLINS
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 336-885-1830