GENESIS THERAPEUTIC SERVICES INC. NPI 1497882195

NPI Information

  • NPI: 1497882195
  • Provider Name: GENESIS THERAPEUTIC SERVICES, INC.
  • Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
  • Entity Type: Organization
  • Address: 99 VILLAGE DR STE 12
    JACKSONVILLE, NC
    ZIP 28546
  • Phone: (910) 577-8200

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NPI Details

GENESIS THERAPEUTIC SERVICES, INC. is a residential treatment facility, intellectual and/or developmental disabilities in Jacksonville, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. GENESIS THERAPEUTIC SERVICES, INC. NPI is 1497882195. The provider is registered as an organization entity type.

The provider's business location address is:

99 VILLAGE DR STE 12
JACKSONVILLE, NC
ZIP 28546-060
Phone: (910) 577-8200
Fax: (910) 577-8270

The provider's authorized official is Kendrick Rogers .
The authorized official title is Program Director and has the following contact phone number (910) 577-8200.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-067-165NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18300858BMEDICAIDNORTH CAROLINA
28300859MEDICAIDNORTH CAROLINA
38300858GMEDICAIDNORTH CAROLINA
48300859GMEDICAIDNORTH CAROLINA
58300858MEDICAIDNORTH CAROLINA
63409583MEDICAIDNORTH CAROLINA
78300859BMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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