Healthcare Provider Details

I. General information

NPI: 1720876238
Provider Name (Legal Business Name): GENESIS HEALING CENTER NC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 INGRAM RIDGE CT
KNIGHTDALE NC
27545-6668
US

IV. Provider business mailing address

423 INGRAM RIDGE CT
KNIGHTDALE NC
27545-6668
US

V. Phone/Fax

Practice location:
  • Phone: 984-308-2924
  • Fax:
Mailing address:
  • Phone: 984-308-2924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BRIANA MCGAHEE
Title or Position: MANAGING MEMBER
Credential:
Phone: 919-800-1020