NPIMap

Organization Active NPI

New Genesisi Residential Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Gastonia, NC
National Provider Identifier
1275652430
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL 036 238 Issued in NC
Legal business name
NEW GENESISI RESIDENTIAL SERVICES, INC.
Practice address
300 Downey PL
Gastonia, NC 28054-3903
Phone
(704) 691-1526
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Arnold England
Title
Chief Executive Officer
Phone
(336) 432-3190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL 036 238 NC Primary

Addresses

Primary practice location

300 Downey PL
Gastonia, NC 28054-3903

Mailing address

1613 W Garrison Blvd
Gastonia, NC 28052-3635
Phone (704) 687-9001

Other identifiers 1

IdentifierTypeStateIssuer
6603968MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Charlespointe Children'S Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1613 W Garrison Blvd
Gastonia, NC 28052

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275652430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 W GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280523635",
            "telephone_number": "704-687-9001",
            "fax_number": "704-867-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 DOWNEY PL",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543903",
            "telephone_number": "704-691-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW GENESISI RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENGLAND",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "336-432-3190"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL 036 238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603968",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.