NPIMap

Organization Active NPI

Genuwine Personal Care, LLC

  • Community/Behavioral Health Agency
  • Gastonia, NC
National Provider Identifier
1699897587
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
8301733 Issued in NC
Legal business name
GENUWINE PERSONAL CARE, LLC
Practice address
1331 E Garrison Blvd
Ste a
Gastonia, NC 28054-5141
Phone
(704) 907-6261
NPI assigned
Apr 4, 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
Beverly Gaither, QMHP, QDDP
Title
Director
Phone
(704) 907-6261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 8301733 NC Primary

Addresses

Primary practice location

1331 E Garrison Blvd
Ste a
Gastonia, NC 28054-5141

Mailing address

1331 E Garrison Blvd
Ste a
Gastonia, NC 28054-5141
Phone (704) 907-6261

Other identifiers 1

IdentifierTypeStateIssuer
8301733MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Genuwine Personal Care LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699897587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 E GARRISON BLVD",
            "address_2": "STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545141",
            "telephone_number": "704-907-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 E GARRISON BLVD",
            "address_2": "STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545141",
            "telephone_number": "704-907-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENUWINE PERSONAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAITHER",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-907-6261",
        "authorized_official_credential": "QMHP, QDDP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "8301733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301733",
            "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.