Provider Demographics
NPI:1528394582
Name:GENESIS A NEW BEGINNING
Entity Type:Organization
Organization Name:GENESIS A NEW BEGINNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR WELLNESS PROMOTION
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:MESIMER
Authorized Official - Last Name:INSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCAS
Authorized Official - Phone:704-687-7414
Mailing Address - Street 1:11 UNION ST S
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-5059
Mailing Address - Country:US
Mailing Address - Phone:704-720-7770
Mailing Address - Fax:
Practice Address - Street 1:11 UNION ST S
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5059
Practice Address - Country:US
Practice Address - Phone:704-720-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health