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NPI Code Detail

MEDICARE: GENESIS DAY

MEDICARE: GENESIS DAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811491434
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENESIS DAY
Provider Business Mailing Address
First Line : 2301 TANFIELD DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-0814
Country : US
Telephone Number : 786-610-9538
Fax Number :
Provider Business Practice Location Address
First Line : 420 HAWTHORNE LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-2312
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2018
Last Update Date : 12/13/2023

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Directions to “ GENESIS DAY ” Practice Location

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