OrganizationActive
Genesis Family Home
NPI 1104044353 · Emotionally Disturbed Childrens' Residential Treatment Facility · Concord, NC
Provider details
- NPI number
- 1104044353
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- John Edmond, Executive Director(704) 793-9593
- License
- MHL-013-096 (NC)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense MHL-013-096 (NC)
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
484 Cook St Nw
Concord, NC 28025-4441
Phone: (704) 793-9593
Street-level locationGet directions
Mailing address
1036 Branchview Dr
Concord, NC 28025-2998
Registry dates
- Enumerated
- 2007-04-23
- Last updated
- 2008-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.