NPIMap

Organization Active NPI

Genesis Youth Crisis Center, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Parsons, WV
National Provider Identifier
1609383298
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
GENESIS YOUTH CRISIS CENTER, INC.
Practice address
413 Chestnut Street
Parsons, WV 26287
Phone
(304) 709-7020
Fax
(304) 399-9115
NPI assigned
Jan 4, 2018
Last updated
Jan 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Authorized official

Name
Edward Matthew Rudder
Title
Chief Executive Officer
Phone
(304) 622-1907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

413 Chestnut Street
Parsons, WV 26287

Mailing address

PO Box 546
Clarksburg, WV 26302
Phone (304) 622-1907

Other names 1

  • Ridgeline Children's Shelter Other name

National Provider Directory

National Provider Directory
Tax ID family
Genesis Youth Crisis Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1609383298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26302",
            "telephone_number": "304-622-1907",
            "fax_number": "304-623-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 CHESTNUT STREET",
            "city": "PARSONS",
            "state": "WV",
            "postal_code": "26287",
            "telephone_number": "304-709-7020",
            "fax_number": "304-399-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS YOUTH CRISIS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "RUDDER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "304-622-1907"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeline Children's Shelter",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Parsons, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.