Genesis Project 1
Genesis Project 1 is a Point of Service in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2014.
- Licensed in
- NC
- In the registry since
- 2014
Practice location Address checks out
5108 Reagan Dr Ste 14Charlotte, NC 28206-3103
Phone: (704) 596-0505
Fax: (704) 596-0507
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Point of Service (primary) | Taxonomy 305S00000X · Licence P009049 (NC) |
|---|
Record details
| NPI number | 1417364480 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Trasha Black — Clinical Director · (704) 596-0505 |
| NPI enumerated | July 22, 2014 |
| Last updated in NPPES | July 22, 2014 |
| Mailing address | 5108 Reagan Dr, Suite 14, Charlotte, NC 28206-3103 |
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