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General NPI Number Information
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NPI Number | 1932681301
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Entity Type | Organization
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Legal Business Name | GENUINE CARE YOUTH AND ADULT SERVICES LLC
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Dates
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Enumeration Date | 09/03/2018
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Last Update Date | 09/03/2018
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Provider Practice Location Address
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Address Line | 2750 E WT HARRIS BLVD STE 121
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City | CHARLOTTE
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State | NC
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Zip | 28213-0034
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Country | US
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Telephone | 704-273-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 E WT HARRIS BLVD STE 121
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City | CHARLOTTE
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State | NC
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Zip | 28213-0034
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Country | US
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Telephone | 704-273-4000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MOHAMMED ALRAWAJFEH
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Credential |
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Telephone | 704-273-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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