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General NPI Number Information
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NPI Number | 1730811936
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Entity Type | Organization
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Legal Business Name | NU GENESIS INTEGRATIVE SOLUTIONS
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 1448 GROVE PARK DR APT 1704
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City | COLUMBUS
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State | GA
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Zip | 31904-1599
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Country | US
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Telephone | 334-744-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 GROVE PARK DR APT 1704
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City | COLUMBUS
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State | GA
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Zip | 31904-1599
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Country | US
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Telephone | 133-474-4113
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA BODY
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Credential |
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Telephone | 334-744-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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