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GENESIS FAMILY HOME
NPI 1104044353
Residential Treatment Facility, Emotionally Disturbed Children in Concord, NC

Active since April 23, 2007
484 COOK ST NW, CONCORD, NC 28025(704) 793-9593 Get Directions Write a Review

NPPES record last updated: June 13, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Genesis Family Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS FAMILY HOME (NPI 1104044353) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Concord, North Carolina and active in the NPI registry since April 2007. The organization lists John Kennedy Edmond, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104044353
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameGENESIS FAMILY HOME
Location Address484 COOK ST NWConcord, NC 28025-4441
Mailing Address1036 Branchview Dr, SuiteConcord, NC 28025-2998 · (704) 793-9593
Phone(704) 793-9593
Organization SubpartNo
Authorized OfficialJohn Kennedy EdmondExecutive Director · (704) 793-9593
Enumeration DateApril 23, 2007
Last NPPES UpdateJune 13, 2008
✔ NPI 1104044353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
License✔ Licensed in NC · MHL-013-096
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
484 COOK ST NW, Concord, NC 28025
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Other Identifiers 1

Medicaid6603333NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Family Home's NPI number?

The NPI number for Genesis Family Home is 1104044353. It was assigned to this organization in the NPPES registry on April 23, 2007.

Where is Genesis Family Home located?

Genesis Family Home is located at 484 Cook St NW, Concord, NC 28025. The listed phone number is (704) 793-9593.

What is Genesis Family Home's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Genesis Family Home was last updated on June 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.