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General NPI Number Information
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NPI Number | 1548383920
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Entity Type | Organization
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Legal Business Name | GENESIS CARE SERVICES, INC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 309 NASH ST
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-5726
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Country | US
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Telephone | 252-414-0265
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Fax | 800-605-9238
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Provider Business Mailing Address
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Address Line | PO BOX 1071
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City | ROCKY MOUNT
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State | NC
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Zip | 27802-1071
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Country | US
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Telephone | 252-414-0265
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Fax | 800-605-9238
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Authorized Official
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Title or Position | CEO
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Name | MR. TIMOTHY MACK
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Credential |
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Telephone | 252-314-2893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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